Amniotic fluid neutrophil gelatinase‐associated lipocalin and L‐type fatty acid‐binding protein in predicting fetal inflammatory response syndrome

Abstract

Aim To analyze the effectiveness of amniotic fluid neutrophil gelatinase‐associated lipocalin and L‐type fatty acid‐binding protein as predictive factors for fetal inflammatory response syndrome. Methods We classified single pregnancy cases into the fetal inflammatory response syndrome and nonfetal inflammatory response syndrome groups. We collected amniotic fluid at vaginal delivery and cesarean section and compared the patient characteristics, maternal white blood cell count, C‐reactive protein level, and amniotic fluid interleukin‐6; neutrophil gelatinase‐associated lipocalin; and L‐type fatty acid‐binding protein levels between the groups. We further analyzed the relationship between L‐type fatty acid‐binding protein levels and neonatal clinical outcomes. Results We analyzed 129 pregnancies, of which 36 and 93 (27.9% and 72.1%, respectively) were classified into the fetal inflammatory response syndrome and nonfetal inflammatory response syndrome groups, respectively. We observed significant differences in the maternal white blood cell counts and amniotic fluid interleukin‐6 and neutrophil gelatinase‐associated lipocalin levels. On the multivariate analysis, the useful predictive factors were maternal white blood cell count and amniotic fluid interleukin‐6 and neutrophil gelatinase‐associated lipocalin levels. Furthermore, the level of L‐type fatty acid‐binding protein was significantly higher in the transient tachypnea of the newborn and postnatal respiratory support group than in the control group. Conclusions The maternal white blood cell count and amniotic interleukin‐6 and neutrophil gelatinase‐associated lipocalin levels were effective predictors of fetal inflammatory response syndrome. Amniotic fluid L‐type fatty acid‐binding protein level was an effective predictor of neonatal respiratory support.

Evaluation of amniotic fluid neutrophil gelatinase-associated lipocalin and L-type fatty acid-binding protein levels during pregnancy

“… [21] This study showed that the amniotic fluid NGAL level was strongly associated with intra-amniotic infection without being affected by other factors, and it was a useful predictor of FIRS, which is similar to the finding of a previous report. [4] There was also a higher NGAL level in the vaginally collection and blood contamination groups, and this may have been due to more inflammatory cells present in the cervix, vagina, and maternal blood.…”

“…Various amniotic fluid biomarkers have been reported, such as neutrophil elastase, lactate dehydrogenase, white blood cell, glucose, [1] interleukin-6, [2] and matrix metalloproteinase-9 levels, [3] for predicting intra-amniotic infection. We previously reported novel amniotic fluid biomarkers: the amniotic fluid neutrophil gelatinase-associated lipocalin (NGAL) level as a useful predictive factor of fetal inflammatory response syndrome (FIRS) [4] and L-type fatty acid-binding protein (L-FABP) as a useful predictive factor of fetal hypoxia. [5] Urinary NGAL and L-FABP levels are useful in detecting acute kidney injury caused by septic shock.…”

Evaluating the IL‐6 Family of Cytokines Throughout Equine Gestation

“…The additional members of this family (IL-27, IL-35, and IL-39) were identified more recently as being heterodimeric cytokines with a common subunit encoded by Epstein-Barr virus-induced gene 3 (EB13) [17]. Currently, elevated IL-6 is utilized as a biomarker for pregnancy dysfunction, and has been implicated or associated with chorioamnionitis [8,11,18,19], preeclampsia [20][21][22], and premature rupture of membranes [7,[23][24][25], and this elevation in IL-6 has been noted during placental disease in the horse [5,12,[26][27][28]. Little research has been done to assess IL-6 or its associated family members during healthy pregnancy.…”

Diagnostic accuracy of amniotic fluid interleukin‐6 for fetal inflammatory response syndrome

“…Reports indicate that IAI diagnosed in amniotic fluid specimens is associated with FIRS. [12][13][14][15] Of particular interest are cases with preterm premature rupture of membranes (PPROM), but IL-6 and tumor necrosis factor (TNF-α) were measured using amniotic fluid that accumulated in the vagina as a sample. A report showed that the diagnostic accuracy for FIRS and the area under the receiver operating characteristic curve (AUROC) were notably high at a maximum of 0.94 when IL-6 or TNF-α was combined with the findings of maternal inflammation.…”

“…However, further studies are needed to clarify its diagnostic accuracy. Reports indicate that IAI diagnosed in amniotic fluid specimens is associated with FIRS 12–15 . Of particular interest are cases with preterm premature rupture of membranes (PPROM), but IL‐6 and tumor necrosis factor (TNF‐α) were measured using amniotic fluid that accumulated in the vagina as a sample.…”