Differential expression pattern of genes encoding for anti-microbial peptides in the fetal membranes of patients with spontaneous preterm labor and intact membranes and those with preterm prelabor rupture of the membranes

Figures & data

Table I.  Demographic and clinical characteristics of the study groups.

	PPROM without chorioamnionitis (n = 17)	PPROM with chorioamnionitis (n = 21)	p-value*	Preterm labor intact membranes without chorioamnionitis (n = 15)	Preterm labor intact membranes with chorioamnionitis (n = 12)	p-value^†
Maternal age (years)	27 [22–31]	27 [22–34]	NS	24 [20–28]	21 [18–30]	NS
Ethnic origin (%)
African-American	14 (82.4)	19 (90.5)	NS	13 (86.7)	10 (83.3)	NS
Caucasian	3 (17.6)	2 (9.5)		2 (13.3)	2 (16.7)
Gravidity	3 [1.5–6]	4 [2.5–5.5]	NS	3 [1–4]	3 [1.3–3]	NS
Parity	2 [0–3.5]	2 [1–4]	NS	1 [1–2]	0.5 [0–1]	NS
Positive amniotic fluid culture (%)^§	0	6 (46.2)	0.051	0	3 (30)	NS
Gestational age at diagnosis (weeks)	31 [30–32.9]	30 [25.6–31.4]	NS	25.9 [23.0–31.0]	28.9 [25.5–32]	NS
Gestational age at delivery (weeks)	31.7 [30.1–33.1]	31 [29.1–32.3]	NS	28.7 [23.7–32.4]	29.1 [25.6–32]	NS
Diagnosis-to-delivery interval (days)	1 [0–5]	3 [1–10]	NS	3 [1–5]	1 [0–6.5]	NS
Birth-weight (g)	1530 [1365–1850]	1700 [995–1920]	NS	1020 [680–1780]	1045 [670–1683]	NS
Female fetus (%)	5 (29.4)	7 (33.3)	NS	4 (26.7)	7 (58.3)	NS

Values are presented as median [interquartile range] or number (percentage).

PPROM, preterm prelabor rupture of the membranes.

*Comparisons between two groups were performed with the Mann-Whitney test.

^†The Fisher's exact test.

^§PPROM (n = 8); PPROM with chorioamnionitis (n = 14); PTL (n = 11); PTL with chorioamnionitis (n = 10).

Table II.  Microorganisms detected in positive amniotic fluid cultures.

	PPROM with chorioamnionitis (n = 14)	Preterm labor intact membranes with chorioamnionitis (n = 10)
Ureoplasma ureolyticum	3	1
Mycoplasma hominis	1	2
Gardnerella vaginalis	2	–
Lactobacillus species	–	1
Prevotella species	1	–
Candida albicans	1	–

Figure 1.  α-defensin 1 mRNA expression in the fetal membranes of patients with spontaneous preterm labor (PTL) or preterm prelabor rupture of membranes (PPROM). In the presence of histologic chorioamnionitis, there was an increased expression among patients with preterm labor with intact membranes (19.4-fold, p < 0.001) or PPROM (2.7-fold, p = 0.08). The amount of α-defensin 1 mRNA was higher in the fetal membranes of patients presenting with preterm labor with intact membranes and histologic chorioamnionitis than in patients with PPROM and histologic chorioamnionitis (5.5-fold, p = 0.003).

Figure 2.  Calgranulin B mRNA expression in the fetal membranes of patients with spontaneous preterm labor intact membranes or preterm prelabor rupture of membranes (PPROM). The expression was increased in patients with preterm labor intact membranes (7.9-fold, p = 0.03) or in those with PPROM (7.6-fold, p < 0.0001) when histologic chorioamnionitis was present. The amount of calgranulin B mRNA was higher in the fetal membranes of patients presenting with preterm labor with intact membranes without histologic chorioamnionitis than in those with PPROM without histologic chorioamnionitis (2.7-fold, p = 0.03). There was no difference in calgranulin B mRNA expression in the fetal membranes between patients with preterm labor with intact membranes or PPROM when histologic chorioamnionitis was present (p = 0.07).