Increased sTREM-1 in pregnant women with premature rupture of membranes and subclinical chorioamnionitis

Abstract

Premature rupture of membranes (PROM) is a common obstetric complication frequently occurring with concomitant chorioamnionitis. The present study aimed to evaluate levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in serum and amniotic fluid in pregnant women with PROM and to compare sTREM-1 with the commonly used laboratory indicators, serum C-reactive protein (CRP) and white blood cell (WBC) count. A total of 55 pregnant women with PROM were enrolled. Their venous blood and amniotic fluid were collected at delivery. sTREM-1 concentrations in the serum and amniotic fluid were determined by enzyme-linked immunosorbent assay. The measured data were compared with the pathological results of the placenta and fetal membrane. Meanwhile, sTREM-1 was compared with the laboratory indicators, serum CRP and WBC count. Serum and amniotic fluid sTREM-1 levels were significantly higher in pregnant women with subclinical chorioamnionitis compared to pregnant women without chorioamnionitis. Serum concentration of sTREM-1 yielded a sensitivity of 81.8% and a specificity of 77.3% for the prediction of subclinical chorioamnionitis. The amniotic fluid concentration of sTREM-1 resulted in a sensitivity of 81.8% and a specificity of 86.4% for the prediction of subclinical chorioamnionitis. In conclusion, serum and amniotic fluid sTREM-1 levels may emerge as early biological indicators for predicting PROM complicated with subclinical chorioamnionitis. sTREM-1 levels are superior to WBC count in predicting subclinical chorioamnionitis.