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Martinez-Portilla RJ, Hawkins-Villarreal A, Alvarez-Ponce P, Chinolla-Arellano ZL, Moreno-Espinosa AL, Sandoval-Mejia AL, Moreno-Uribe N. Maternal Serum Interleukin-6: A Non-Invasive Predictor of Histological Chorioamnionitis in Women with Preterm-Prelabor Rupture of Membranes. Fetal Diagn Ther 2018; 45:168-175. [PMID: 29635237 DOI: 10.1159/000488080] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 02/27/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the added value of maternal serum levels of IL-6 in women with preterm-prelabor rupture of membranes (PPROM) as a non-invasive test for the prediction of histological chorioamnionitis (HCA). METHODS This was a prospective cohort study of pregnant women between 20 + 0 and 36 + 6 weeks of gestation with a confirmed diagnosis of PPROM. Logistic regression models were created for the prediction of HCA and compared by assessing the improvement in their Naegelkerke R2 as a measure of goodness of fit. Predictive performance of all models was assessed by receiver operating characteristics curve (ROC) analysis and compared by the DeLong method. RESULTS From 47 women with PPROM, 31 (66%) developed HCA. Maternal serum IL-6 ≥19.5 pg/dL was the best cut-off point for the prediction of HCA (OR = 15; 95% CI: 3.6-61; p < 0.01). A model comprising maternal characteristics and IL-6 ≥19.5 pg/dL showed an area under the curve of 0.85 (95% CI: 0.74-0.95), significantly improving the previous models of IL-6 ≥19.5 pg/dL (R2: 23.3 vs. 34.1%; p = 0.01) or maternal characteristics (R2: 8.4 vs. 34.1%; p < 0.01). CONCLUSIONS A model comprising maternal serum levels of IL-6 plus maternal characteristics proves to be a good non-invasive predictor of HCA.
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Affiliation(s)
- Raigam Jafet Martinez-Portilla
- Fetal Medicine Unit, Obstetrics Department, Hospital "La Raza" Medical Center, Autonomous University of Mexico, Mexico City, .,Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut Clínic de Ginecologia, Obstetricia i Neonatologia, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, .,Fetal Diagnostic Center, Clínica Hospital Sinai, Xalapa,
| | - Ameth Hawkins-Villarreal
- Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut Clínic de Ginecologia, Obstetricia i Neonatologia, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain.,Fetal Medicine Service, Obstetrics Department, Hospital "Santo Tomas", University of Panama, Panama City, Panama
| | - Pamela Alvarez-Ponce
- Fetal Medicine Unit, Obstetrics Department, Hospital "La Raza" Medical Center, Autonomous University of Mexico, Mexico City, Mexico
| | - Zarela Lizbeth Chinolla-Arellano
- Fetal Medicine Unit, Obstetrics Department, Hospital "La Raza" Medical Center, Autonomous University of Mexico, Mexico City, Mexico
| | - Ana Lisbeth Moreno-Espinosa
- Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut Clínic de Ginecologia, Obstetricia i Neonatologia, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain.,Fetal Medicine Service, Obstetrics Department, Hospital "Santo Tomas", University of Panama, Panama City, Panama
| | - Ana Lilia Sandoval-Mejia
- Fetal Medicine Unit, Obstetrics Department, Hospital "La Raza" Medical Center, Autonomous University of Mexico, Mexico City, Mexico
| | - Nallely Moreno-Uribe
- Fetal Medicine Unit, Obstetrics Department, Hospital "La Raza" Medical Center, Autonomous University of Mexico, Mexico City, Mexico
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