Objective The purpose of this study was to evaluate the predictive value of vaginal fluid
biomarkers for
chorioamnionitis and adverse perinatal outcomes in women with preterm premature
rupture of membranes (
PPROM). Methods We recruited women with
PPROM, without clinical
chorioamnionitis, between 22 and 36 weeks' gestation. Vaginal fluid was collected on admission for the measurement of metalloproteinase-8 (MMP-8),
interleukin-6 (IL-6),
lactate, and
glucose concentration. Placental pathology and neonatal charts were reviewed. Primary outcomes were histological
chorioamnionitis and adverse neonatal neurological outcomes (intraventricular
hemorrhage grade 2 or 3,
periventricular leukomalacia, or
hypoxic/ischemic encephalopathy). Linear regression analyses were used to adjust for gestational age at
PPROM. Results Twenty-seven women were recruited at a mean gestational age of 31.6 ± 3.1 weeks, including 25 (93%) with successful collection of vaginal fluid sample. Histological
chorioamnionitis and adverse neonatal neurological outcomes were observed in nine (33%) and four (15%) cases, respectively. In univariate analysis, MMP-8,
IL-6,
glucose, and
lactate concentrations in vaginal fluid were associated with the risk of
chorioamnionitis but not anymore after adjustment for gestational age at
PPROM. MMP-8 concentration was the only
biomarker associated with adverse neurological outcome, and it remained significant after adjustment for gestational age at
PPROM (p = 0.02). Conclusion Vaginal fluid inflammatory
biomarkers at admission for
PPROM could predict adverse perinatal outcomes.