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Amniotic fluid CA-125 as a marker of intra-amniotic inflammation associated with preterm delivery: a preliminary single center study

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

The purpose of this study was to investigate whether amniotic fluid (AF) CA-125 in patients with preterm labor or preterm premature rupture of membranes can help predict intra-amniotic inflammation (IAI), microbial invasion of the amniotic cavity (MIAC) and imminent delivery.

Methods

We recruited 36 women who admitted with impending preterm delivery and suspicious AF infection. AF matrix metalloproteinase-8 (MMP-8), white blood cell (WBC) count, glucose levels, and CA-125 levels were measured, and the MMP-8 bedside rapid test was also performed. AF culture and PCR were subsequently performed to confirm MIAC. We compared AF CA-125 levels according to the presence of IAI or MIAC and assessed its predictive value for delivery within 7 days of admission.

Results

AF CA-125 levels were significantly higher in the IAI group than in the non-IAI group (mean ± standard deviation: 5608 ± 864 vs 904 ± 84 IU/ml; p = 0.001). AF CA-125 levels showed a negative correlation with gestational age and a positive correlation with AF WBC counts and MMP-8 levels. AF CA-125 levels were higher in the MIAC group, though this difference was not statistically significant (p = 0.064). Delivery within 7 days of admission was significantly more common in patients with higher AF CA-125 levels (cut-off: 1650 IU/ml, sensitivity: 71.4 %, specificity: 86.4 %, p = 0.005).

Conclusion

AF CA-125 levels are increased in patients with AF inflammation and can be a predictor of imminent preterm delivery.

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References

  1. Gomez R, Romero R, Edwin SS, David C (1997) Pathogenesis of preterm labor and preterm premature rupture of membranes associated with intraamniotic infection. Infect Dis Clin North Am 11:135–176

    Article  PubMed  CAS  Google Scholar 

  2. Yoon BH, Romero R, Moon JB, Shim SS, Kim M, Kim G et al (2001) Clinical significance of intra-amniotic inflammation in patients with preterm labor and intact membranes. Am J Obstet Gynecol 185:1130–1136

    Article  PubMed  CAS  Google Scholar 

  3. Gotsch F, Romero R, Kusanovic JP, Mazaki-Tovi S, Pineles BL, Erez O et al (2007) The fetal inflammatory response syndrome. Clin Obstet Gynecol 50:652–683

    Article  PubMed  Google Scholar 

  4. Christiaens I, Zaragoza DB, Guilbert L, Robertson SA, Mitchell BF, Olson DM (2008) Inflammatory processes in preterm and term parturition. J Reprod Immunol 79:50–57

    Article  PubMed  CAS  Google Scholar 

  5. Biggio JR Jr, Ramsey PS, Cliver SP, Lyon MD, Goldenberg RL, Wenstrom KD (2005) Midtrimester amniotic fluid matrix metalloproteinase-8 (MMP-8) levels above the 90th percentile are a marker for subsequent preterm premature rupture of membranes. Am J Obstet Gynecol 192:109–113

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  6. Locksmith GJ, Clark P, Duff P, Schultz GS (1999) Amniotic fluid matrix metalloproteinase-9 levels in women with preterm labor and suspected intra-amniotic infection. Obstet Gynecol 94:1–6

    Article  PubMed  CAS  Google Scholar 

  7. Park CW, Lee SM, Park JS, Jun JK, Romero R, Yoon BH (2008) The antenatal identification of funisitis with a rapid MMP-8 bedside test. J Perinat Med 36:497–502

    PubMed  PubMed Central  Google Scholar 

  8. Kim KW, Romero R, Park HS, Park CW, Shim SS, Jun JK et al (2007) A rapid matrix metalloproteinase-8 bedside test for the detection of intraamniotic inflammation in women with preterm premature rupture of membranes. Am J Obstet Gynecol 197:292.e1–5

  9. Meden H, Fattahi-Meibodi A (1998) CA 125 in benign gynecological conditions. Int J Biol Markers 13:231–237

    PubMed  CAS  Google Scholar 

  10. Bischof P (1993) What do we know about the origin of CA 125? Eur J Obstet Gynecol Reprod Biol 49:93–98

    Article  PubMed  CAS  Google Scholar 

  11. Sarandakou A, Protonotariou E, Rizos D (2007) Tumor markers in biological fluids associated with pregnancy. Crit Rev Clin Lab Sci 44:151–178

    Article  PubMed  CAS  Google Scholar 

  12. Barbati A, Anceschi MM, Alberti P, Pomili G, Di Renzo GC, Cosmi EV (1989) Ontogeny of CA 125 antigen in pregnancy: immunoradiometric determination in amniotic fluid and immunohistochemical localization in fetal membranes. Am J Obstet Gynecol 160:514–517

    Article  PubMed  CAS  Google Scholar 

  13. Kosar F, Aksoy Y, Ozguntekin G, Ozerol I, Varol E (2006) Relationship between cytokines and tumour markers in patients with chronic heart failure. Eur J Heart Fail 8:270–274

    Article  PubMed  CAS  Google Scholar 

  14. Arntzen KJ, Kjøllesdal AM, Halgunset J, Vatten L, Austgulen R (1998) TNF, IL-1, IL-6, IL-8 and soluble TNF receptors in relation to chorioamnionitis and premature labor. J Perinat Med 26:17–26

    Article  PubMed  CAS  Google Scholar 

  15. Saji F, Samejima Y, Kamiura S, Sawai K, Shimoya K, Kimura T (2000) Cytokine production in chorioamnionitis. J Reprod Immunol 47:185–196

    Article  PubMed  CAS  Google Scholar 

  16. Van Lint P, Libert C (2006) Matrix metalloproteinase-8: cleavage can be decisive. Cytokine Growth Factor Rev 17:217–223

    Article  PubMed  Google Scholar 

  17. Maymon E, Romero R, Pacora P, Gomez R, Athayde N, Edwin S et al (2000) Human neutrophil collagenase (matrix metalloproteinase 8) in parturition, premature rupture of the membranes, and intrauterine infection. Am J Obstet Gynecol 183:94–99

    Article  PubMed  CAS  Google Scholar 

  18. Quirk JG Jr, Brunson GL, Long CA, Bannon GA, Sanders MM, O’Brien TJ (1988) CA 125 in tissues and amniotic fluid during pregnancy. Am J Obstet Gynecol 159:644–649

    Article  PubMed  Google Scholar 

  19. Williams MA, Hickok DE, Zingheim RW, Zebelman AM (1993) Maternal serum CA 125 levels in the diagnosis of abruptio placentae. Obstet Gynecol 82:808–812

    PubMed  CAS  Google Scholar 

  20. Mazor M, Bashiri A, Ghezzi F, Maymon E, Kuperman O, Kopernik G et al (1996) Maternal serum CA 125 is of prognostic value in patients with uterine bleeding in the detection of small-for-gestational-age neonates. Eur J Obstet Gynecol Reprod Biol 67:143–147

    Article  PubMed  CAS  Google Scholar 

  21. Wei SQ, Fraser W, Luo ZC (2010) Inflammatory cytokines and spontaneous preterm birth in asymptomatic women: a systematic review. Obstet Gynecol 116:393–401

    Article  PubMed  Google Scholar 

  22. Lee SM, Lee KA, Kim SM, Park CW, Yoon BH (2011) The risk of intra-amniotic infection, inflammation and histologic chorioamnionitis in term pregnant women with intact membranes and labor. Placenta 32:516–521

    Article  PubMed  Google Scholar 

  23. DiGiulio DB, Romero R, Kusanovic JP, Gómez R, Kim CJ, Seok KS et al (2010) Prevalence and diversity of microbes in the amniotic fluid, the fetal inflammatory response, and pregnancy outcome in women with preterm pre-labor rupture of membranes. Am J Reprod Immunol 64:38–57

    PubMed  PubMed Central  Google Scholar 

  24. Consonni S, Mainini V, Pizzardi A, Gianazza E, Chinello C, Locatelli A et al (2014) Non-invasively collected amniotic fluid as a source of possible biomarkers for premature rupture of membranes investigated by proteomic approach. Arch Gynecol Obstet 289:299–306

    Article  PubMed  CAS  Google Scholar 

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The authors have no commercial, proprietary, or financial interest in the products or companies described in this article.

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Correspondence to Won Joon Seong.

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Seong, W.J. Amniotic fluid CA-125 as a marker of intra-amniotic inflammation associated with preterm delivery: a preliminary single center study. Arch Gynecol Obstet 293, 55–59 (2016). https://doi.org/10.1007/s00404-015-3775-1

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  • DOI: https://doi.org/10.1007/s00404-015-3775-1

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