Amniocentesis Research Today is a free monthly online journal that collates and summarizes the latest research about Amniocentesis, including details on pregnancy, prenatal screening, diagnosis, risks, down syndrome.

Elevated Mid-Trimester Amniotic Fluid ADAM-8 Concentrations as a Potential Risk Factor for Preterm Delivery.

Vrachnis N, Malamitsi-Puchner A, Samoli E, Botsis D, Iliodromiti Z, Baka S, Hassiakos D, Creatsas G

Second Department of Obstetrics and Gynecology, Aretaeion Hospital, University of Athens, Greece; Department of Hygiene and Epidemiology, Medical School, University of Athens, Athens, Greece.

OBJECTIVE: To determine during mid-trimester amniocentesis if elevated concentrations of ADAM-8 (A Disintegrin And Metalloprotease 8) and/or cortisol can recognize women at risk for spontaneous preterm delivery. METHODS: The study involved 312 women who underwent mid-trimester amniocentesis. Thirteen patients, who progressed to preterm delivery, were matched with 21 controls for age, parity, gestational age at amniocentesis, and year of amniocentesis. ADAM-8 and cortisol levels were measured by enzyme-linked immunosorbent assay and radioimmunoassay, respectively. RESULTS: ADAM-8 mean amniotic fluid concentrations were significantly higher in women with preterm delivery than in women delivering at term (mean 1213.9 [SE 96.7] pg/mL [range, 780 to 1854 pg/mL] vs mean 937.2 [SE 50.3] pg/mL [range, 486 to 1508 pg/mL], P <.02). Amniotic fluid ADAM-8 concentrations higher than 1149 pg/mL had the highest specificity and odds ratio (OR) in the identification of the women with increased risk for preterm delivery (sensitivity 61.5%; specificity 81.7%; OR, 9.6 [95% confidence interval (CI), 1.8 to 50.3]). Women with preterm delivery had suggestively higher amniotic fluid concentrations of cortisol (mean 1.3 [SE 0.2] mug/dL [range, 0.4 to 2.2 mug/dL]) than women delivering at term (mean 1.0 [SE 0.09] mug/dL [range, 0.6 to 1.7 mug/dL], P <.07). Furthermore, cortisol levels were positively correlated with ADAM-8 levels (Spearman's r = .418, P <.014). CONCLUSIONS: Elevated mid-trimester amniotic fluid ADAM-8 concentrations possibly are a risk factor for preterm delivery, particularly if ADAM-8 levels are greater than 1149 pg/mL. Potential intrauterine inflammation is also associated with suggestively increased amniotic fluid cortisol levels.

Published 26 April 2006 in J Soc Gynecol Investig, 13(3): 186-90.
Full-text of this article is available online (may require subscription).

© 2005-2008 Amniocentesis Research Today. All Rights Reserved.