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Amniotic fluid proteomic signatures of cervical insufficiency and their association with length of latency

Authors :
Vanessa Poliquin
Savas Menticoglou
Adam Burgener
Kenzie Birse
Shadi Sepehri
Rachelle Govia
Ehsan Khafipour
Source :
American Journal of Reproductive Immunology. 80:e13030
Publication Year :
2018
Publisher :
Wiley, 2018.

Abstract

Cervical insufficiency is a precursor of preterm birth. Treatment with emergency cervical cerclage is contraindicated in the presence of intra-amniotic infection. Detecting infection with Gram stain and culture of amniotic fluid lacks sensitivity. Proteomic profiling of amniotic fluid in cervical insufficiency may help identify pregnancies best suited for emergency cerclage.Thirty-two pregnant women underwent amniocentesis for routine genetic testing (n = 22) or after diagnosis of cervical insufficiency (n = 10). The proteomic profiles of the amniotic fluid samples were compared in a cross-sectional fashion, including sub-analyses of women with cervical insufficiency and latency periods of1 week and1 week post-diagnosis.Mean gestational age at diagnosis of cervical insufficiency was 21.4 weeks (95% CI 20.6-22.1). Proteomic analysis yielded 40 (7.2%, P 0.05) differentially expressed proteins between women with delivery1 week (n = 6) vs.1 week (n = 4). Women who delivered1 week had activated inflammatory response (z = 2.3, P = 6.71E-09), chemotaxis of immune cells (z = 2.9, P = 2.01E-08), and inhibited bacterial growth (z = -2.2, P = 5.82E-05). A multivariate model of eight biomarkers positively associated with cases of1 week latency and distinguished cases from controls (97.8%, cross-validation accuracy 92.7%, P = 0.0009).In this pilot study, significant differences in the amniotic fluid proteomic profiles in cases of cervical insufficiency compared to genetic amniocentesis were observed. Proteomic signatures were predictive of achieving latency1 week after diagnosis of cervical insufficiency. These preliminary findings suggest that proteomic analysis may be of value in predicting outcome following cervical insufficiency and warrants further validation in larger studies.

Details

ISSN :
10467408
Volume :
80
Database :
OpenAIRE
Journal :
American Journal of Reproductive Immunology
Accession number :
edsair.doi.dedup.....dacf66dd984663afb43a6f67d8964170