Intraamniotic inflammatory response to bacteria: analysis of multiple amniotic fluid proteins in women with preterm prelabor rupture of membranes

Marian Kacerovsky*, Ivana Musilova, Ali Khatibib, Kristin Skogstrandd, David M. Hougaardd, Vojtech Tambore, Jindrich Tosnera & Bo Jacobssona Department of Obstetrics and Gynecology, Faculty of Medicine Hradec Kralove, Charles University in Prague, University Hospital Hradec Kralove, Hradec Kralove, Czech Republicb Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Swedenc Department of Obstetrics and Gynecology, Hospital Pardubice, Pardubice, Czech Republicd Department of Clinical Biochemistry and Immunology, Statens Serum Institut, Copenhagen, Denmarke Biomedical Research Center, University Hospital Hradec Kralove, Hradec Kralove, Czech Republicf Institute of Public Health, Oslo, NorwayCorrespondence: Marian Kacerovsky, MD, Department of Obstetrics and Gynecology, Charles University, University Hospital, Sokolska 581, 500 05 Hradec Kralove, Czech Republic. Tel: +420–777657991; Direct: +420–495832676. E-mail: kacermar@fnhk.czObjective: To analyse whether intraamniotic inflammation in response to bacteria is different below and above gestational age 32 weeks in pregnancies complicated by preterm prelabor rupture of membranes (PPROM). Methods: A prospective study was performed, and 115 women with singleton pregnancies complicated by PPROM at gestational ages between 240/7 and 366/7 weeks were included in the study. Transabdominal amniocenteses were performed. Amniotic fluid was analysed using polymerase chain reactions for genital mycoplasmas and cultured for aerobic and anaerobic bacteria. The concentrations of 26 proteins in the amniotic fluid were determined simultaneously using multiplex technology. Results: Bacteria were found in the amniotic fluid of 43% (49/115) of the women. The women were stratified into two subgroups according to gestational age 32 weeks. The amniotic fluid levels of four (interleukin-6, interleukin-10, CC chemokine ligands 2, and 3) and one specific (CC chemokine ligands 2) proteins were higher in women with the presence of bacteria in the amniotic fluid below and above 32 gestational weeks, respectively. Conclusions: An intraamniotic inflammatory response to bacteria in pregnancies complicated by PPROM seems to be different below and above 32 weeks of gestation.