Mid-trimester maternal plasma cytokines and CRP as predictors of spontaneous preterm birth

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• 作者：Michael S. Kramer ; Susan R. Kahn ; Robert W. Platt ; Jacques Genest ; Moy Fong Chen ; Lise Goulet ; Louise S&#xe9 ; guin ; John Lydon ; Helen McNamara ; Michael Libman ; Mourad Dahhou ; Julie Lamoureux ; Kristin S
• 关键词：Preterm birth ; Maternal immune response ; Cytokines ; Matrix metalloproteinase
• 刊名：Cytokine
• 出版年：2010
• 出版时间：January 2010
• 年：2010
• 卷：49
• 期：1
• 页码：10-14
• 全文大小：153 K

文摘

Most previous studies of maternal cytokines and preterm birth have analyzed immunologic biomarkers after the onset of labor or membrane rupture; fewer have examined the systemic (blood) immune response prior to labor onset. We carried out a case–control study nested in a large (n = 5337) prospective, multi-center cohort. Cohort women had an interview, examination, and venipuncture at 24–26 weeks. Frozen plasma samples in women with spontaneous preterm birth (n = 207) and approximately 2 term controls per case (n = 444) were analyzed using Luminex multianalyte profiling technology. Fresh placentas were fixed, stained, and blindly assessed for histologic evidence of infection/inflammation, decidual vasculopathy, and infarction, and vaginal swabs were analyzed for bacterial vaginosis and fetal fibronectin concentration. High maternal matrix metalloproteinase-9 (MMP-9) concentration, but none of the other cytokines or C-reactive protein (CRP), was significantly associated with spontaneous preterm birth [adjusted OR = 1.7 (1.1–2.4)] and showed a dose–response relation across quartiles. No association was observed, however, between maternal MMP-9 and placental infection/inflammation, bacterial vaginosis, or vaginal fetal fibronectin concentration. Our results require confirmation in future studies but suggest that a systemic immune response implicating MMP-9 may have an etiologic role in spontaneous preterm birth.