Infectious Diseases in Obstetrics and Gynecology 
Volume 9 (2001), Issue 4, Pages 209-214
doi:10.1155/S1064744901000345

Performance Characteristics of Putative Tests for Subclinical Chorioamnionitis

Rodney K. Edwards,1 Penny Clark,1 Gregory J. Locksmith,2 and Patrick Duff1

1Department of Obstetrics and Gynecology, University of Florida College of Medicine, PO Box 100294, 1600 SW Archer Road, Gainesville 32610-0294, FL, USA
2Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Medical Branch, Galveston, TX, USA

Received 10 May 2001; Accepted 24 August 2001

Abstract

Objective: To evaluate amniotic fluid glucose, matrix metalloproteinase (MMP)-9, interleukin (IL)-6, and IL-12 for diagnosing subclinical chorioamnionitis in women with preterm labor.

Methods: Forty-four women in preterm labor at 22–35 weeks gestation with suspected subclinical chorioamnionitis underwentamniocentesis.Amniotic fluid analysis included Gram stain, culture, and determination of glucose, MMP-9, IL-6, and IL-12 concentrations. Median values of these analytes were compared using the Mann-Whitney U test. Sensitivity, specificity, and positive and negative predictive values were calculated for tests using a positive amniotic fluid culture or delivery within 24 hours as the key outcome variables

Results: Amniotic fluid concentrations of glucose, MMP-9, and IL-6 correlated closely with positive culture or delivery within 24 hours. IL-12 concentrations did not correlate with either a positive culture or delivery within 24 hours.

Conclusions: Amniotic fluid glucose, MMP-9, and IL-6 reliably predict microbial invasion of the amniotic cavity or imminent delivery. IL-12 values did not correlate with amniotic fluid culture results or imminent delivery.