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Original Article

Evidence for complement activation in the amniotic fluid of women with spontaneous preterm labor and intra-amniotic infection

, , , , , , , , , & show all
Pages 983-992 | Received 18 Feb 2009, Accepted 09 Apr 2009, Published online: 17 Mar 2010

Figures & data

Table I.  Demographic and clinical characteristics of women who underwent amniocentesis at midtrimester and term gestation not in labor and in spontaneous labor.

Table II.  Demographic and clinical characteristics of women with spontaneous preterm labor and intact membranes.

Figure 1.  Amniotic fluid anaphylatoxins concentrations from women in the midtrimester (14–18 weeks of gestation) who delivered a normal neonate at term and those at term not in labor. A and B: There were no differences in the median amniotic fluid concentrations of C3a and C4a between pregnant women in the midtrimester and those at term not in labor [C3a: median 371.2 ng/ml, (range 130.4–2468.2) vs. median 463.1 ng/ml, (range 161.9–1131.3); p = 0.1] and [C4a: median 96.3 ng/ml, (range 13.8–326.2) vs. median 70.7 ng/ml, (range 21.4–184.4); p = 0.2]; C: In contrast, the median amniotic fluid concentration of C5a was significantly higher in women at term not in labor than in those in the midtrimester [median 4.8 ng/ml, (range 1.7–18.1) vs. median 1.8 ng/ml, (range 0.07–46.3); p = 0.002].

Figure 1.  Amniotic fluid anaphylatoxins concentrations from women in the midtrimester (14–18 weeks of gestation) who delivered a normal neonate at term and those at term not in labor. A and B: There were no differences in the median amniotic fluid concentrations of C3a and C4a between pregnant women in the midtrimester and those at term not in labor [C3a: median 371.2 ng/ml, (range 130.4–2468.2) vs. median 463.1 ng/ml, (range 161.9–1131.3); p = 0.1] and [C4a: median 96.3 ng/ml, (range 13.8–326.2) vs. median 70.7 ng/ml, (range 21.4–184.4); p = 0.2]; C: In contrast, the median amniotic fluid concentration of C5a was significantly higher in women at term not in labor than in those in the midtrimester [median 4.8 ng/ml, (range 1.7–18.1) vs. median 1.8 ng/ml, (range 0.07–46.3); p = 0.002].

Figure 2.  Amniotic fluid anaphylatoxins concentrations of normal pregnant women at term. A, B, C: There were no significant differences in the median amniotic fluid concentrations of C3a, C4a, and C5a between women at term in labor and those not in labor [C3a: median 463.1 ng/ml (range 161.9–1131.3) vs. median 447.5 ng/ml (range 12.3–1196.3; p = 0.8]; [C4a: median 70.7 ng/ml (range 21.4–184.4) vs. median 55.3 ng/ml (range 0.6–217.1; p = 0.9]; and [C5a: median 4.8 ng/ml (range 1.7–18.1) vs. median 3.2 ng/ml (range 0.07–17.1); p = 0.1].

Figure 2.  Amniotic fluid anaphylatoxins concentrations of normal pregnant women at term. A, B, C: There were no significant differences in the median amniotic fluid concentrations of C3a, C4a, and C5a between women at term in labor and those not in labor [C3a: median 463.1 ng/ml (range 161.9–1131.3) vs. median 447.5 ng/ml (range 12.3–1196.3; p = 0.8]; [C4a: median 70.7 ng/ml (range 21.4–184.4) vs. median 55.3 ng/ml (range 0.6–217.1; p = 0.9]; and [C5a: median 4.8 ng/ml (range 1.7–18.1) vs. median 3.2 ng/ml (range 0.07–17.1); p = 0.1].

Figure 3.  Amniotic fluid anaphylatoxins concentrations in patients with preterm labor. A: Patients with preterm delivery and MIAC had a median amniotic fluid C3a concentration higher than those who in preterm labor and delivered at term [median: 671.9 ng/ml (range 312.8 – 3552.9) vs. median: 506 ng/ml (range 184.5 – 1992.8)]. There was no difference in the median amniotic fluid C3a concentration between patients in preterm labor who delivered at term and those who delivered preterm without MIAC. Similarly, there was no difference in the median amniotic fluid C3a concentration between patients with preterm delivery and MIAC and those without MIAC. B, Patients with preterm delivery and MIAC had a higher median amniotic fluid C4a concentration than those who had a preterm delivery without MIAC [median: 351.7 ng/ml (range 24.8 – 1640.4) vs. median: 139.5 ng/ml (range 0.6 – 1377.4)]. Similarly, patients with preterm delivery and MIAC had a higher median amniotic fluid C4a concentration than those who had preterm labor a delivered at term [median: 351.7 ng/ml (range 24.8 – 1640.4) vs. median: 97.2 ng/ml (range 130.4 – 2468.2)]. In contrast, there was no difference between the median amniotic fluid C4a concentration of women who had a preterm delivery without MIAC and those who had preterm labor and delivery at term. C: Patients with preterm delivery and MIAC had a higher median amniotic fluid C5a concentration than those who had a preterm delivery without MIAC [median: 8.5 ng/ml (range 2.2 – 83.2) vs. median: 4.9 ng/ml (range 0.07 – 400)]. Similarly, patients with preterm delivery and MIAC had a higher median amniotic fluid C5a concentration than those who had preterm labor a delivered at term [median: 8.5 ng/ml (range 2.2 – 83.2) vs. median: 4.4 ng/ml (range 0.5 – 83.5)]. In contrast, there was no difference between the median amniotic fluid C5a concentration in women who had a preterm delivery without MIAC and those who had preterm labor and delivery at term.

Figure 3.  Amniotic fluid anaphylatoxins concentrations in patients with preterm labor. A: Patients with preterm delivery and MIAC had a median amniotic fluid C3a concentration higher than those who in preterm labor and delivered at term [median: 671.9 ng/ml (range 312.8 – 3552.9) vs. median: 506 ng/ml (range 184.5 – 1992.8)]. There was no difference in the median amniotic fluid C3a concentration between patients in preterm labor who delivered at term and those who delivered preterm without MIAC. Similarly, there was no difference in the median amniotic fluid C3a concentration between patients with preterm delivery and MIAC and those without MIAC. B, Patients with preterm delivery and MIAC had a higher median amniotic fluid C4a concentration than those who had a preterm delivery without MIAC [median: 351.7 ng/ml (range 24.8 – 1640.4) vs. median: 139.5 ng/ml (range 0.6 – 1377.4)]. Similarly, patients with preterm delivery and MIAC had a higher median amniotic fluid C4a concentration than those who had preterm labor a delivered at term [median: 351.7 ng/ml (range 24.8 – 1640.4) vs. median: 97.2 ng/ml (range 130.4 – 2468.2)]. In contrast, there was no difference between the median amniotic fluid C4a concentration of women who had a preterm delivery without MIAC and those who had preterm labor and delivery at term. C: Patients with preterm delivery and MIAC had a higher median amniotic fluid C5a concentration than those who had a preterm delivery without MIAC [median: 8.5 ng/ml (range 2.2 – 83.2) vs. median: 4.9 ng/ml (range 0.07 – 400)]. Similarly, patients with preterm delivery and MIAC had a higher median amniotic fluid C5a concentration than those who had preterm labor a delivered at term [median: 8.5 ng/ml (range 2.2 – 83.2) vs. median: 4.4 ng/ml (range 0.5 – 83.5)]. In contrast, there was no difference between the median amniotic fluid C5a concentration in women who had a preterm delivery without MIAC and those who had preterm labor and delivery at term.

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