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A rapid interleukin-6 bedside test for the identification of intra-amniotic inflammation in preterm labor with intact membranes
- Source :
- The Journal of Maternal-Fetal & Neonatal Medicine
- Publication Year :
- 2015
- Publisher :
- Informa UK Limited, 2015.
-
Abstract
- Objective: Preterm birth is associated with 5–18% of pregnancies and is the leading cause of neonatal morbidity and mortality. Amniotic fluid (AF) interleukin-6 (IL-6) is a key cytokine for the identification of intra-amniotic inflammation, and patients with an elevated AF IL-6 are at risk for impending preterm delivery. However, results of the conventional method of measurement (enzyme-linked immunosorbent assay; ELISA) are usually not available in time to inform care. The objective of this study was to determine whether a point of care (POC) test or lateral-flow-based immunoassay for measurement of AF IL-6 concentrations can identify patients with intra-amniotic inflammation and/or infection and those destined to deliver spontaneously before term among women with preterm labor and intact membranes. Methods: One-hundred thirty-six women with singleton pregnancies who presented with symptoms of preterm labor and underwent amniocentesis were included in this study. Amniocentesis was performed at the time of diagnosis of preterm labor. AF Gram stain and AF white blood cell counts were determined. Microbial invasion of the amniotic cavity (MIAC) was defined according to the results of AF culture (aerobic and anaerobic as well as genital mycoplasmas). AF IL-6 concentrations were determined by both lateral flow-based immunoassay and ELISA. The primary outcome was intra-amniotic inflammation, defined as AF ELISA IL-6 ≥ 2600 pg/ml. Results: (1) AF IL-6 concentrations determined by a POC test have high sensitivity (93%), specificity (91%) and a positive likelihood ratio of 10 for the identification of intra-amniotic inflammation by using a threshold of 745 pg/ml; (2) the POC test and ELISA for IL-6 perform similarly in the identification of MIAC, acute inflammatory lesions of placenta and patients at risk of impending spontaneous preterm delivery. Conclusion: A POC AF IL-6 test can identify intra-amniotic inflammation in women who present with preterm labor and intact membranes and those who will subsequently deliver spontaneously before 34 weeks of gestation. Results can be available within 20 min – this has important clinical implications and opens avenues for early diagnosis as well as treatment of intra-amniotic inflammation/infection.
- Subjects :
- Adult
medicine.medical_specialty
Acute chorioamnionitis
Amniotic fluid
Point-of-Care Systems
Point-of-care testing
acute funisitis
Chorioamnionitis
microbial invasion of the amniotic cavity
Article
Young Adult
03 medical and health sciences
Obstetric Labor, Premature
0302 clinical medicine
Pregnancy
medicine
Humans
030212 general & internal medicine
Young adult
Retrospective Studies
Point of care
030219 obstetrics & reproductive medicine
medicine.diagnostic_test
Interleukin-6
Obstetrics
business.industry
prematurity
biomarkers
preterm birth
Obstetrics and Gynecology
Retrospective cohort study
Amniotic Fluid
medicine.disease
Pediatrics, Perinatology and Child Health
point of care test
Amniocentesis
Female
Original Article
ELISA
business
Subjects
Details
- ISSN :
- 14764954 and 14767058
- Volume :
- 29
- Database :
- OpenAIRE
- Journal :
- The Journal of Maternal-Fetal & Neonatal Medicine
- Accession number :
- edsair.doi.dedup.....43de20fb89f5318ab8ae4225fb55f37d