Shen Di, Ju Hui, Wang Hongying, Wang Xietong, Li Guangzhen
Department of Obstetrics and Gynaecology, Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China.
Department of Obstetrics and Gynecology, Liao Cheng People's Hospital, Liaocheng, China.
Front Cell Infect Microbiol. 2025 Apr 4;15:1510671. doi: 10.3389/fcimb.2025.1510671. eCollection 2025.
The objective of this study is to explore whether metagenomic next-generation sequencing (mNGS) and Epithelial Neutrophil Activating Peptide-78 (ENA-78) assays in the amniotic fluid (AF) of patients with preterm labor (PTL) could be employed for diagnosing intra-amniotic infection/inflammation (IAI/I) and predict the outcomes of emergency cerclage in women with cervical insufficiency(CI).
AF samples from 40 patients were subjected to PTL were subjected to mNGS and microbial culture to diagnose intra-amniotic infection known as microbial invasion of the amniotic cavity (MIAC); ELISA was used to analyze ENA-78 levels for prediction of intra-amniotic inflammation (IAI). Pregnancy outcomes were compared, the predictive performance of mNGS and ENA-78 were assessed to evaluate the efficacy of emergency cervical cerclage.
The diagnosis rate of MIAC was higher with mNGS (17.5%) compared to microbial culture (2.5%). AF ENA-78 levels were significantly higher in IAI patients than in non-IAI/I patients. ENA-78 demonstrated certain accuracy in identifying IAI, with sensitivity and specificity of 73.3% and 100%, respectively. Compared with non-IAI/I patients, patients with MIAC or IAI exhibited poor pregnancy outcomes after cervical cerclage.
mNGS and ENA-78 assays are valuable means for assessing the state of infection/inflammation in the amniotic cavity and predicting the outcomes of emergency cerclage.
本研究旨在探讨早产（PTL）患者羊水（AF）中的宏基因组下一代测序（mNGS）和上皮中性粒细胞激活肽78（ENA-78）检测能否用于诊断羊膜腔内感染/炎症（IAI/I），并预测宫颈机能不全（CI）女性紧急宫颈环扎术的结局。
对40例PTL患者的AF样本进行mNGS和微生物培养，以诊断羊膜腔内感染，即羊膜腔微生物入侵（MIAC）；采用酶联免疫吸附测定（ELISA）分析ENA-78水平，以预测羊膜腔内炎症（IAI）。比较妊娠结局，评估mNGS和ENA-78的预测性能，以评价紧急宫颈环扎术的疗效。
与微生物培养（2.5%）相比，mNGS诊断MIAC的阳性率更高（17.5%）。IAI患者的AF ENA-78水平显著高于非IAI/I患者。ENA-78在识别IAI方面具有一定的准确性，敏感性和特异性分别为73.3%和100%。与非IAI/I患者相比，MIAC或IAI患者宫颈环扎术后的妊娠结局较差。
mNGS和ENA-78检测是评估羊膜腔感染/炎症状态及预测紧急宫颈环扎术结局的有价值方法。
