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Non-invasive prediction of intra-amniotic inflammation in women with preterm labor

Authors
 H. J. JUNG  ;  K. H. PARK  ;  S. N. KIM  ;  J.-S. HONG  ;  K. J. OH  ;  G. KIM  ;  J. Y. KWON 
Citation
 ULTRASOUND IN OBSTETRICS & GYNECOLOGY, Vol.37(1) : 82-87, 2011 
Journal Title
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
ISSN
 0960-7692 
Issue Date
2011
MeSH
Adult ; Amniocentesis ; Amniotic Fluid/microbiology* ; Bacterial Infections/diagnosis* ; Bacterial Infections/microbiology ; C-Reactive Protein/analysis* ; Cervical Length Measurement/methods ; Chorioamnionitis/diagnosis* ; Female ; Gestational Age ; Humans ; Labor Stage, First ; Leukocyte Count ; Male ; Models, Biological ; Obstetric Labor, Premature*/microbiology ; Palpation/methods ; Pregnancy ; Pregnancy Complications, Infectious/diagnosis* ; Pregnancy Complications, Infectious/microbiology ; ROC Curve ; Regression Analysis
Keywords
cervical length ; gestational age ; intra-amniotic inflammation ; preterm labor ; white blood cell count.
Abstract
OBJECTIVE: To develop a model based on non-invasive variables to predict the probability of intra-amniotic inflammation in women with preterm labor and intact membranes.

METHODS: Transvaginal ultrasonography and digital examination for the assessment of cervical length and cervical dilatation were performed, and maternal blood was collected for the determination of C-reactive protein and white blood cell (WBC) count immediately after amniocentesis in 153 consecutive women with preterm labor. Amniotic fluid obtained by amniocentesis was cultured for aerobic and anaerobic bacteria and mycoplasmas, and the WBC was determined. Intra-amniotic inflammation was defined as an elevated amniotic fluid interleukin-6 concentration (> 2.6 ng/mL). Receiver-operating characteristics (ROC) curves and logistic regression analysis were used for statistical analysis.

RESULTS: The prevalence of a positive amniotic fluid culture was 7.2% (11/153) and the prevalence of intra-amniotic inflammation was 19.6% (30/153). The final logistic regression model was based on non-invasive clinical variables, including gestational age at assessment, cervical length and maternal blood WBC count, which were the best predictors of intra-amniotic inflammation. The model was shown to have an adequate goodness of fit (P = 0.754), and the area under the ROC curve was 0.724, indicating reasonably good discrimination.

CONCLUSION: In women with preterm labor and intact membranes, the risk for intra-amniotic inflammation can be predicted non-invasively with a risk score based on gestational age, cervical length and maternal blood WBC count.
Files in This Item:
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DOI
10.1002/uog.8869
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Ja Young(권자영) ORCID logo https://orcid.org/0000-0003-3009-6325
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/93108
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