Department of Obstetrics & Gynecology, Japan.
Department of Obstetrics and Gynecology, National Hospital Organization Saga Hospital, Saga, Japan.
Placenta. 2021 Oct;114:68-75. doi: 10.1016/j.placenta.2021.08.059. Epub 2021 Aug 26.
Clinical prediction of foetal inflammatory response syndrome (FIRS) is highly necessary. We have previously reported that miR-4535 and miR-1915-5p are potential biomarkers for severe chorioamnionitis based on the results of microRNA array analysis. Therefore, we evaluated the relationship between foetal morbidity of infection and miR-4535, miR-1915-5p, interleukin (IL)-6, or 16S rDNA copy number levels in amniotic fluid from pregnant women with chorioamnionitis.
Amniotic fluid from 57 pregnant women with preterm premature membrane rupture or threatened premature labour were collected. Infants with WBC counts <5000/μL or >20,000/μL, CRP >0.5 mg/mL, or IgM >20 mg/mL at birth received a diagnosis of suspicious foetal infection, and those requiring antibiotic administration for >5 days were considered infected newborns. miR-4535, miR-1915-5p, and IL-6 levels and 16S rDNA copy number were evaluated. Mann-Whitney U test and Dunn's test were used for comparison. The area under the curve (AUC) and Youden index were calculated to examine the diagnostic accuracy of foetal morbidity of infection.
miR-4535, miR-1915-5p, 16S rDNA, and IL-6 were significantly higher in patients with severe chorioamnionitis than in patients with chorionitis or sub-chorionitis (P < 0.05). miR-4535 and miR-1915-5p levels were significantly associated with WBC counts <5000/μL or >20,000/μL, CRP >0.5 mg/mL, or IgM >20 mg/mL (P < 0.05). AUC values of miR-4535 and miR-1915-5p indicated moderate or low accuracy for foetal morbidity of infection, while those of IL-6 and 16S rDNA seemed unreliable.
MiR-4535 and miR-1915-5p levels in amniotic fluid may be considered clinically predictive for foetal morbidity of infection.
临床预测胎儿炎症反应综合征（FIRS）非常必要。我们之前曾报道过，基于 miRNA 芯片分析的结果，miR-4535 和 miR-1915-5p 是严重绒毛膜羊膜炎的潜在生物标志物。因此，我们评估了绒毛膜羊膜炎孕妇羊水中 miR-4535、miR-1915-5p、白细胞介素（IL）-6 或 16S rDNA 拷贝数水平与胎儿感染发病率之间的关系。
收集 57 例早产胎膜早破或先兆早产孕妇的羊水。出生时白细胞计数<5000/μL 或>20000/μL、CRP>0.5mg/mL 或 IgM>20mg/mL 的婴儿被诊断为可疑胎儿感染，需要抗生素治疗>5 天的婴儿被认为是感染新生儿。评估 miR-4535、miR-1915-5p 和 IL-6 水平和 16S rDNA 拷贝数。采用 Mann-Whitney U 检验和 Dunn 检验进行比较。计算曲线下面积（AUC）和 Youden 指数以评估胎儿感染发病率的诊断准确性。
重度绒毛膜羊膜炎患者的 miR-4535、miR-1915-5p、16S rDNA 和 IL-6 水平明显高于绒毛膜炎或绒毛膜下炎患者（P<0.05）。miR-4535 和 miR-1915-5p 水平与白细胞计数<5000/μL 或>20000/μL、CRP>0.5mg/mL 或 IgM>20mg/mL 显著相关（P<0.05）。miR-4535 和 miR-1915-5p 的 AUC 值表明对胎儿感染发病率的准确性为中等或低，而 IL-6 和 16S rDNA 的 AUC 值似乎不可靠。
羊水 miR-4535 和 miR-1915-5p 水平可作为胎儿感染发病率的临床预测指标。
