Diagnostic value of amniotic fluid inflammatory biomarkers for subclinical chorioamnionitis

Abstract

ObjectiveTo determine the value of measuring amniotic fluid inflammatory biomarkers for diagnosis of subclinical chorioamnionitis. MethodsA prospective study was conducted among pregnant women with cervical dilation, preterm premature rupture of membranes, threatened late abortion, or threatened premature labor who attended a tertiary care hospital in Guangzhou, China, between June 1, 2012, and January 31, 2014. Participants were divided into two groups according to the presence or absence of subclinical chorioamnionitis. Surface-enhanced laser desorption/ionization time-of-flight mass spectroscopy (SELDI-TOF-MS) was used to detect human neutrophil defensins (HNP-1 and HNP-2), calgranulins A (S100A8), and calgranulins C (S100A12) in amniocentesis samples. ResultsOverall, 22 patients had subclinical chorioamnionitis and 17 patients did not. Positive test results for HNP-2 were noted for more patients with subclinical chorioamnionitis than for those without for HNP-2 (19 [86%] vs 2 [12%]; P<0.001), HNP-1 (19 [86%] vs 5 [29%]; P=0.001), S100A12 (20 [91%] vs 9 [53%]; P=0.011), and S100A8 (12 [55%] vs 0; P<0.001). When three or four of these biomarkers were present, the accuracy for a diagnosis of subclinical chorioamnionitis was 89.7%. The sensitivity, specificity, positive predictive value, and negative predictive value were 81.8%, 100.0%, 100.0%, and 81.0%, respectively. ConclusionDetection of inflammatory biomarkers in the amniotic fluid by SELDI-TOF-MS exhibited high diagnostic accuracy for subclinical chorioamnionitis.