By testing for four proteins in fetus-cushioning amniotic fluid, doctors can predict when pregnant women are at risk of delivering preterm and when their infants are at risk for severe infections, according to a presentation today at the annual meeting of the Society for Maternal-Fetal Medicine.
Dr. Catalin S. Buhimschi, from Yale University in New Haven, Connecticut, and his associates used imaging mass spectrometry to obtain a protein “fingerprint” of amniotic fluid obtained from women who delivered preterm and identified 13 proteins associated with inflammation.
With further study, they found four proteins that are “accurate and sufficient to diagnose amniotic fluid inflammation,” Buhimschi told Reuters Health.
Moreover, test results can be obtained within 30 minutes, versus the 4 to 5 hours required for standard tests.
To test the accuracy of these four proteins, the researchers followed 135 consecutive women presenting with symptoms of preterm labor.
By checking for these four proteins, “we were able to assess the risk of premature delivery,” Buhimschi said. In the absence of any of the identified proteins, the patients delivered at term. “Among those with one or two of the proteins present, delivery took place after a median time of 4 days. For those with three or four proteins, delivery took place within hours.”
The researchers also observed a correlation between the state of inflammation diagnosed by these four proteins and the development of sepsis in the newborn. Sepsis is a dangerous immune reaction to infection or injury that can cause blood pressure to plummet or organs to fail.
“The presence of inflammation suggests for neonatologists that the baby may have sepsis, and they can initiate antibiotics much faster than if they waited (for) the results of blood cultures,” Buhimschi said.
“Up until now we have not had a gold standard for inflammation,” Buhimschi added. “This study, I believe, creates a gold standard for our specialty, because it correlates with neonatal outcome.”
For their research, Buhimschi’s team received the March of Dimes annual award.
Revision date: July 9, 2011
Last revised: by Jorge P. Ribeiro, MD