Neutrophil granule products: can they identify subclinical chorioamnionitis in patients with preterm premature rupture of membranes?

Objective Our purpose was to determine whether maternal plasma levels of neutrophil granule products are elevated in patients with chorioamnionitis after preterm premature rupture of membranes (PROM). Study design Fifty-two patients between 24 and 34 weeksʹ gestation with preterm PROM were included. Plasma samples for defensins and lactoferrin were collected throughout latency. Fifty-two control subjects between 26 and 30 weeksʹ gestation were recruited for baseline levels. Results Mean control defensin levels were compared with mean defensin levels on admission (668 ng/mL vs 5665 ng/mL, P<.01). Mean defensin levels on admission in patients without chorioamnionitis were compared with those of patients in whom histologic chorioamnionitis developed (520 ng/mL vs 9163 ng/mL, P<.01). The same relationships were not demonstrated for lactoferrin. With use a defensin value of 1500 ng/mL on admission, the sensitivity is 76% and specificity is 94% in predicting histologic chorioamnionitis. Conclusions Maternal plasma levels of defensins are markers of histologic chorioamnionitis in patients after preterm PROM.