Visfatin/Pre-B cell colony-enhancing factor in amniotic fluid in normal pregnancy, spontaneous labor at term, preterm labor and prelabor rupture of membranes: an association with subclinical intrauterine infection in preterm parturition

被引:68
作者
Mazaki-Tovi, Shali [1 ,2 ,3 ]
Romero, Roberto [1 ,2 ,4 ]
Kusanovic, Juan Pedro [1 ,2 ,3 ]
Erez, Offer [1 ,2 ,3 ]
Gotsch, Francesca [1 ,2 ]
Mittal, Pooja [1 ,2 ,3 ]
Than, Nandor Gabor [1 ,2 ]
Nhan-Chang, Chia-Lang [1 ,2 ,3 ]
Hamill, Neil [1 ,2 ,3 ]
Vaisbuch, Edi [1 ,2 ,3 ]
Chaiworapongsa, Tinnakorn [1 ,2 ,3 ]
Edwin, Samuel S. [1 ,2 ]
Nien, Jyh Kae [5 ]
Gomez, Ricardo [5 ]
Espinoza, Jimmy [1 ,2 ,3 ]
Kendal-Wright, Claire [6 ]
Hassan, Sonia S. [1 ,2 ,3 ]
Bryant-Greenwood, Gillian [6 ]
机构
[1] NICHD, Perinatol Res Branch, Intramural Div, NIH,DHHS,Hutzel Womens Hospital, Detroit, MI 48201 USA
[2] NICHD, Perinatol Res Branch, Intramural Div, NIH,DHHS,Hutzel Womens Hospital, Bethesda, MD USA
[3] Wayne State Univ, Dept Obstet & Gynecol, Hutzel Womens Hosp, Detroit, MI USA
[4] Wayne State Univ, Ctr Mol Med & Genet, Detroit, MI USA
[5] Pontificia Univ Catolica Chile, Hosp Sotero Rio, Ctr Perinatal Diag & Res CEDIP, Puente Alto, Chile
[6] Univ Hawaii, John A Burns Sch Med, Dept Obstet Gynecol & Womens Hlth, Honolulu, HI 96822 USA
关键词
Microbial invasion of the amniotic cavity (MIAC); pre-B cell colony-enhancing factor (PBEF); preterm labor; preterm prelabor rupture of membranes (preterm PROM); visfatin;
D O I
10.1515/JPM.2008.084
中图分类号
R71 [妇产科学];
学科分类号
100211 [妇产科学];
摘要
Objective: Visfatin, a novel adipokine originally discovered as a pre-B-cell colony enhancing factor, is expressed by amniotic epithelium, cytotrophoblast, and decidua and is over-expressed when fetal membranes are exposed to mechanical stress and/or pro-inflammatory stimuli. Visfatin expression by fetal membranes is dramatically up-regulated after normal spontaneous labor. The aims of this study were to determine if visfatin is detectable in amniotic fluid (AF) and whether its concentration changes with gestational age, spontaneous labor, preterm prelabor rupture of membranes (preterm PROM) and in the presence of microbial invasion of the amniotic cavity (MIAC). Methods: In this cross-sectional study, visfatin concentration in AF was determined in patients in the following groups: 1) mid-trimester (n=75); 2) term not in labor (n=27); 3) term in spontaneous labor (n=51); 4) patients with preterm labor with intact membranes (PTL) without MIAC who delivered at term (n=35); 5) patients with PTL without MIAC who delivered preterm (n=52); 6) patients with PTL with MIAC (n=25); 7) women with preterm PROM without MIAC (n=26); and 8) women with preterm PROM with MIAC (n=26). Non-parametric statistics were used for analysis. Results: 1) The median AF concentration of visfatin was significantly higher in patients at term than in mid-trimester; 2) Among women with PTL who delivered preterm, the median visfatin concentration was significantly higher in patients with MIAC than those without MIAC; 3) Similarly, patients with PTL and MIAC had a higher median AF visfatin concentration than those with PTL who delivered at term; 4) Among women with preterm PROM, the median AF visfatin concentration was significantly higher in patients with MIAC than those without MIAC. Conclusions: 1) Visfatin is a physiologic constituent of AF; 2) The concentration of AF visfatin increases with advancing gestational age; 3) AF visfatin concentration is elevated in patients with MIAC, regardless of the membrane status, suggesting that visfatin participates in the host response against infection.
引用
收藏
页码:485 / 496
页数:12
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