Department of NICU, Fujian Provincial Hospital, Provincal Clinical College of Fujian Medical University, Fuzhou, Fujian 350001, China.
Department of NICU, Fujian Provincial Hospital, Provincal Clinical College of Fujian Medical University, Fuzhou, Fujian 350001, China.
Clin Chim Acta. 2018 Aug;483:286-290. doi: 10.1016/j.cca.2018.04.029. Epub 2018 Apr 22.
Infection and/or inflammation have been proposed play role in the preterm delivery (PTD) pathogenesis. Macrophage migration inhibitory factor(MIF), a mediator of innate immunity and inflammation, is induced in various infections, including those that occur during pregnancy. We assessed the relation between maternal early pregnancy plasma concentrations of MIF and PTD.
Women were recruited before 14 weeks gestation and were followed up until delivery. Maternal plasma concentrations of MIF, C-reactive protein (CRP) and interleukin 6 (IL-6) at first visit were measured by competitive immunoassay. The diagnosis of PTD was made using American College of Obstetricians and Gynaecologists (ACOG) guidelines. Logistic regression procedures were used to calculate adjusted odds ratio (OR) and 95% confidence intervals (95%CI).
In the study period, 596 participants were included. The median plasma concentration of MIF was significantly higher in women in whom PTD later developed compared with those delivering at term (P < 0.001). For each 1 ng/ml increase of plasma concentration of MIF, the unadjusted and adjusted risk of PTD would be increased by 12% (with the OR of 1.12 [95% CI 1.07-1.17], P < 0.001) and 7% (1.07 [1.02-1.15], P = 0.002), respectively. Stratified analyses indicated that increased MIF was associated with an increased risk of spontaneous delivery (OR = 1.16, 95%CI: 1.07-1.24; P < 0.001), indicated delivery (OR = 1.05, 95%CI: 1.01-1.14; P = 0.02), and before 34 weeks' gestation delivery (OR = 1.09, 95%CI: 1.03-1.18). With an AUC of 0.71, MIF showed a significantly greater discriminatory ability as compared with BMI (0.58; 95% CI: 0.52-0.65; P < 0.001), CRP (0.61; 95% CI: 0.54-0.68; P < 0.001) and IL-6(0.63; 95% CI: 0.55-0.69; P = 0.001).
Increased maternal plasma concentrations of MIF at first trimester were associated with increased risk of PTD and might be useful in identifying newborn at risk for PTD for early prevention strategies.
感染和/或炎症被认为在早产（PTD）发病机制中起作用。巨噬细胞移动抑制因子（MIF）是先天免疫和炎症的介质，在各种感染中被诱导，包括在怀孕期间发生的感染。我们评估了母体妊娠早期血浆中 MIF 浓度与 PTD 之间的关系。
在妊娠 14 周之前招募妇女，并跟踪至分娩。通过竞争免疫测定法测量首次就诊时的母体血浆 MIF、C-反应蛋白（CRP）和白细胞介素 6（IL-6）浓度。使用美国妇产科医师学会（ACOG）指南诊断 PTD。使用逻辑回归程序计算调整后的比值比（OR）和 95%置信区间（95%CI）。
在研究期间，纳入了 596 名参与者。与足月分娩的妇女相比，后来发生 PTD 的妇女的 MIF 血浆浓度中位数明显更高（P < 0.001）。MIF 血浆浓度每增加 1ng/ml，未调整和调整的 PTD 风险分别增加 12%（OR 为 1.12 [95%CI 1.07-1.17]，P < 0.001）和 7%（1.07 [1.02-1.15]，P = 0.002）。分层分析表明，MIF 升高与自发性分娩（OR = 1.16，95%CI：1.07-1.24；P < 0.001）、指示分娩（OR = 1.05，95%CI：1.01-1.14；P = 0.02）和 34 周前分娩（OR = 1.09，95%CI：1.03-1.18）的风险增加有关。MIF 的 AUC 为 0.71，与 BMI（0.58；95%CI：0.52-0.65；P < 0.001）、CRP（0.61；95%CI：0.54-0.68；P < 0.001）和 IL-6（0.63；95%CI：0.55-0.69；P = 0.001）相比，具有显著更大的鉴别能力。
妊娠早期母体血浆 MIF 浓度升高与 PTD 风险增加相关，可能有助于识别有早产风险的新生儿，以便早期采取预防策略。
