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Journal of the Society for Gynecologic Investigation, Vol. 13, No. 1, 25-29 (2006)
DOI: 10.1016/j.jsgi.2005.09.008

Elevated Second Trimester Amniotic Fluid Interferon {gamma}-Inducible T-Cell {alpha} Chhemoattractant Concentrations as a Possible Predictor of Preterm Birth

Ariadne Malamitsi-Puchner, MD

Second Department of Obstetrics and Gynecology, Neonatal Division, University of Athens, Medical School, 19, Soultani str, 10682 Athens, Greece malamitsi{at}acn.gr

Nikolaos Vrachnis, MD

Evi Samoli, PhD

Stavroula Baka, MD

Demetrios Hassiakos, MD

George Creatsas, MD, FACS

University of Athens, Medical School Athens, Greece

Objective: To determine and correlate midtrimester amniotic fluid concentrations of interferon {gamma}-inducible T-cell {alpha} chemoattractant (ITAC, a chemokine directing the migration of activated T lymphocytes toward inflammation sites) and C-reactive protein (CRP) in women undergoing amniocentesis and subsequently delivering pre-or full-term infants.

Methods: Among 312 women undergoing midtrimester transabdominal amniocentesis, 13 progressed to spontaneous delivery at less than 37 gestational weeks (GW). Subjects were matched for maternal age, parity, and GW at amniocentesis with 21 controls who delivered at greater than 37 GW. Amniotic fluid ITAC and CRP levels were determined by enzyme-linked immunosorbent assay (ELISA) and by nephelometry, respectively.

Results: Both ITAC and CRP values were significantly higher (P = .005 and P = .04, respectively) in the amniotic fluid of women delivering at less than 37 GW. A statistically significant correlation between amniotic fluid ITAC and CRP concentrations was also found (r = .366 P <.05). The receiver operator curve (ROC) analysis of delivery at less than 37 GW gave the best cutoff point for ITAC at a concentration of 44 PG/mL AND for CRP at a concentration of 0.16 mg/dL. Positive and negative predictive values for ITAC were 82% and 85%, respectively, and for CRP, 55% and 76%, respectively.

Conclusions: Present data indicate that from the second trimester of pregnancy elevated amniotic fluid concentrations of ITAC are found in women delivering at less than 37 GW, as compared to women delivering at term. Therefore, ITAC in combination with other cytokines or CRP could possibly serve as predictor of preterm delivery.

Key Words: Preterm birthh • amniotic fluid • interferon {gamma}-inducible T-cell {alpha} chemoattractant • chemoattractant • second trimester of pregnancy

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