The significance of TNF‐α and MMP‐8 concentrations in non‐invasively obtained amniotic fluid predicting fetal inflammatory response syndrome

Abstract

Objective: To determine the significance of tumor necrosis factorα (TNFα) and matrix metalloproteinase-8 (MMP-8) in vaginally obtained amniotic fluid predicting fetal inflammatory response syndrome (FIRS) after preterm premature rupture of membranes (PPROM). Methods:In this prospective case-control study, TNFα and MMP-8 concentrations were evaluated in vaginally obtained amniotic fluid from women with PPROM at 22-34 weeks of pregnancy. Biomarkers' concentrations were determined using an enzyme-linked immunosorbent assay. Patients were divided into two groups: the FIRS group (cord blood interleukin-6 > 11 pg/ml or histological funisitis) and the non-FIRS group (without these findings). The data were analyzed using R package (R-4.0.5). Results:The median TNFα and MMP-8 concentrations in amniotic fluid from the 145 women included in the study were higher in the FIRS group than in the non-FIRS group. The area under the curve of TNFα and MMP-8 was 0.77 and 0.75, respectively. The TNFα concentration cut-off predicting FIRS was 89.20 pg/ml and was 170.76 pg/ml for MMP-8. In regression analysis, MMP-8 concentration was an independent predictor for FIRS. An MMP-8 concentration greater than 170 ng/ml and a TNFα concentration greater than 89 pg/ml increased the odds of FIRS 7.62 and 14.92 times, respectively.Conclusions: MMP-8 and TNFα concentrations in vaginally obtained amniotic fluid may be good predictors for FIRS after PPROM before 34 weeks of pregnancy.The non-invasive amniotic fluid analysis could be an alternative method to invasive amniocentesis. K E Y W O R D S amniotic fluid, biomarker, fetal inflammatory response syndrome (FIRS), matrix metalloproteinase-8 (MMP-8), non-invasive method, preterm birth, preterm premature rupture of membranes (PPROM), tumor necrosis factorα (TNFα) How to cite this article: Gulbiniene V, Balciuniene G, Dumalakiene I, Viliene R, Pilypiene I, Ramasauskaite D. The significance of TNF-α and MMP-8 concentrations in non-invasively obtained amniotic fluid predicting fetal inflammatory response syndrome.

Soluble Urokinase Plasminogen Activator Receptor in Vaginally Collected Amniotic Fluid Predicting Fetal Inflammatory Response Syndrome: a prospective cohort study

“…Furthermore, we sought to compare the association of suPAR with other amniotic in ammatory biomarkers, such as IL-6, TNF-α, and matrix metalloproteinase-8 (MMP-8). The signi cance of these biomarkers in noninvasively obtained amniotic uid predicting FIRS was reported previously [20,21].…”

“…Patients with inadequate amniotic uid samples, such as insu cient volume or containing mucous and/or blood, were also excluded. Additional amniotic uid biomarkers, whose prognostic value has already been reported in previous publications [20,21], were evaluated during the study. For the assessment of suPAR, due to the association of suPAR with hypertensive diseases, we retrospectively excluded all cases with maternal hypertensive disorders for the suPAR analysis [19].…”

Soluble urokinase plasminogen activator receptor in vaginally collected amniotic fluid predicting fetal inflammatory response syndrome: a prospective cohort study

“…Furthermore, we sought to compare the association of suPAR with other amniotic inflammatory biomarkers, such as IL-6, TNF-α, and matrix metalloproteinase-8 (MMP-8). The significance of these biomarkers in noninvasively obtained amniotic fluid predicting FIRS was reported previously [ 20 , 21 ].…”

Functional MRI assessment of the lungs in fetuses that deliver very Preterm: An MRI pilot study

“…Women with confirmed intra-amniotic infection or intrauterine inflammation diagnosed by raised interleukin levels and matrix degrading enzymes at amniocentesis at 18.9 weeks (median) gestation are at risk of preterm delivery [44] . Elevated cord levels of inflammatory cytokines interleukins IL-1β, IL-6, IL-8 and TNF-α have been reported in prematurely born infants [45] , [46] . Animal models have also indicated that infection and inflammation may alter lung development in utero.…”