Complement C3a, But Not C5a, Levels in Amniotic Fluid Are Associated with Intra-amniotic Infection and/or Inflammation and Preterm Delivery in Women with Cervical Insufficiency or an Asymptomatic Short Cervix (≤ 25 mm).
10.3346/jkms.2018.33.e220
- Author:
Yu Mi KIM
1
;
Kyo Hoon PARK
;
Hyunsoo PARK
;
Ha Na YOO
;
Song Yi KOOK
;
Se Jeong JEON
Author Information
1. Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. pkh0419@snubh.org
- Publication Type:Original Article
- Keywords:
Amniotic Fluid;
Complement C3a, C5a;
Cervical Insufficiency;
Intra-amniotic Infection;
Preterm Delivery
- MeSH:
Amniocentesis;
Amniotic Fluid*;
C-Reactive Protein;
Cervix Uteri*;
Cohort Studies;
Complement C3a*;
Complement System Proteins*;
Enzyme-Linked Immunosorbent Assay;
Female;
Humans;
Inflammation*;
Interleukin-6;
Logistic Models;
Outcome Assessment (Health Care);
Retrospective Studies
- From:Journal of Korean Medical Science
2018;33(35):e220-
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: We aimed to estimate whether elevated levels of complement C3a and C5a in amniotic fluid (AF) are independently associated with increased risks of intra-amniotic infection and/or inflammation (IAI) and spontaneous preterm delivery (SPTD) in women with cervical insufficiency or a short cervix (≤ 25 mm). METHODS: We conducted a retrospective cohort study of 96 consecutive women with cervical insufficiency (n = 62) or a short cervix (n = 34) at 17 to 27 weeks, and who underwent an amniocentesis. AF was cultured and analyzed for C3a and C5a by enzyme-linked immunosorbent assay kits. The primary outcome measures were IAI (defined as a positive AF culture and/or an elevated AF interleukin-6 level [≥ 7.6 ng/mL]) and SPTD at < 32 weeks. RESULTS: In multivariable analysis, AF level of C3a was the only variable significantly associated with IAI, whereas C5a level in AF and serum C-reactive protein level were not associated with IAI. Using SPTD at < 32 weeks as the outcome variable in logistic regression, elevated AF levels of C3a were associated with increased risk of SPTD at < 32 weeks after adjusting for other baseline confounders, whereas elevated AF levels of C5a were not. CONCLUSION: In women with cervical insufficiency or a short cervix, elevated AF level of C3a, but not C5a, is independently associated with increased risks of IAI and SPTD at < 32 weeks. These findings suggest that subclinical IAI or SPTD in the context of cervical insufficiency is related to activation of complement system in AF.
