INFLAMMATION CAN IDENTIFY PATIENTS AT RISK FOR PRETERM DELIVERY WITHIN 7 DAYS JYH KAE NIEN, BO HYUN YOON, JIMMY ESPINOZA, JUAN PEDRO KUSANOVIC, OFFER EREZ, ELEAZAR SOTO, KARINA RICHANI, RICARDO GOMEZ, ROBERTO ROMERO, Perinatology Research Branch, NICHD, NIH, DHHS, Bethesda, Maryland, Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Seoul, South Korea, Wayne State University School of Medicine, Department of Obstetrics and Gynecology, Detroit, Michigan, Sotero del Rio Hospital, Center for Perinatal Diagnosis and Research, Santiago, Chile OBJECTIVE: Matrix metalloproteinase-8 (MMP-8) is an enzyme that is released during neutrophil activation. MMP-8 amniotic fluid (AF) concentrations are elevated in intra-amniotic infection, but also in patients with negative AF cultures who deliver preterm neonates. The objective of this study was to determine if the results of a rapid bedside test (MMP-8 PTL ) predicted delivery within 48 hours and 7 days. This test can be performed in 15 minutes and without laboratory equipment. STUDY DESIGN: AF was retrieved from 331 consecutive patients admitted with preterm labor and intact membranes. AF was processed for microbiology studies, as well as Gram stain, glucose, and white blood cell count. AF was stored and the MMP-8 rapid test was performed after delivery. Endpoints included spontaneous preterm delivery within 48 hours and 7 days. Diagnostic indices, predictive values and likelihood ratios were calculated. RESULTS: The prevalence of spontaneous preterm delivery within 48 hours and 7 days was 12% (41/331) and 21% (70/331), respectively. A positive MMP-8 rapid test was present in 11% (36/331) of our study population. The diagnostic indices of a positive MMP-8 rapid test in the prediction of delivery within 48 hours and 7 days are displayed in the table. CONCLUSION: The MMP-8 rapid test can identify patients at risk for preterm delivery within 7 days. Previous studies have demonstrated that this test can identify intra-amniotic infection and inflammation in preterm PROM and preterm labor with a high sensitivity and specificity.