The clinical significance of eosinophils in the amniotic fluid in preterm labor
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Date
2010
Journal Title
Journal ISSN
Volume Title
Publisher
TAYLOR & FRANCIS LTD
Abstract
Methods. This retrospective case-control study included women who presented with preterm labor and intact membranes between 24 and 34 weeks of gestation. Patients underwent an amniocentesis shortly after admission for the assessment of the microbiologic status of the amniotic cavity and/or fetal lung maturity. Amniotic fluid was cultured for aerobic and anaerobic bacteria as well as genital mycoplasmas. Cytologic studies included amniotic fluid white blood cell count and differential, which was performed on cytocentrifuged specimens. Patients with microbial invasion of the amniotic cavity and/or an amniotic fluid white blood cell count > 20 cells/mm<SU3</SU were excluded from the study. Cases were defined as women in whom the differential contained > 20% of eosinophils. Controls were selected among women with an amniotic fluid eosinophil count < 20% and matched for gestational age at amniocentesis. The analysis was conducted with non-parametric statistics.
Results. The study population consisted of 10 cases and 50 controls. Gestational age and cervical dilatation at admission were similar in both groups. Cases had a lower gestational age at delivery than controls [34.6 weeks, inter-quartile range (IQR) 32-37.3 weeks vs. 38.0 weeks, IQR 35-40 weeks, respectively; p = 0.018]. The prevalence of preterm delivery < 35 weeks was higher among patients who had > 20% eosinophils than in the control group [50% (5/10) vs. 18% (9/50), respectively; p = 0.029]. Similar results were observed for delivery at < 37 weeks [cases: 70% (7/10) vs. controls: 36% (18/50); p = 0.046].
Conclusions. Women with preterm labor and intact membranes who have a large proportion of eosinophils in the amniotic fluid are at an increased risk for spontaneous preterm delivery. These patients may have had an episode of preterm labor related to a type I hypersensitivity reaction.
Results. The study population consisted of 10 cases and 50 controls. Gestational age and cervical dilatation at admission were similar in both groups. Cases had a lower gestational age at delivery than controls [34.6 weeks, inter-quartile range (IQR) 32-37.3 weeks vs. 38.0 weeks, IQR 35-40 weeks, respectively; p = 0.018]. The prevalence of preterm delivery < 35 weeks was higher among patients who had > 20% eosinophils than in the control group [50% (5/10) vs. 18% (9/50), respectively; p = 0.029]. Similar results were observed for delivery at < 37 weeks [cases: 70% (7/10) vs. controls: 36% (18/50); p = 0.046].
Conclusions. Women with preterm labor and intact membranes who have a large proportion of eosinophils in the amniotic fluid are at an increased risk for spontaneous preterm delivery. These patients may have had an episode of preterm labor related to a type I hypersensitivity reaction.
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Keywords
Premature birth, preterm birth, prematurity, premature labor, mast cells, amniotic fluid cells, amniotic fluid white, blood cells, allergy, allergy-induced preterm labor, atopy, pregnancy, type I hypersensitivity reaction, parturition, labor, eosinophil granule proteins, MAJOR BASIC-PROTEIN, ULTRASONOGRAPHIC CERVICAL LENGTH, ENDOTHELIAL GROWTH-FACTOR, COLONY-STIMULATING FACTOR, PREMATURE RUPTURE, INTRAAMNIOTIC INFLAMMATION, AIRWAYS HYPERREACTIVITY, DIFFERENTIATION FACTOR, HUMAN INTERLEUKIN-5, MICROBIAL INVASION