Tumor necrosis factor in preterm and term labor

Robert Romero, Moshe Mazor, Waldo Sepulveda, Cecilia Avila, Diane Copeland, John Williams

Research output: Contribution to journalArticlepeer-review

353 Scopus citations

Abstract

OBJECTIVE: Our objective was to determine of labor (term and preterm) and microbial invasion of the amniotic cavity were associated with changes in amniotic fluid concentrations of tumor necrosis factor. STUDY DESIGN: Amniotic fluid was retrieved by transabdominal amniocentesis from 269 women in the following groups: midtrimester (n = 38), preterm labor with intact membranes (n = 52), preterm premature rupture of membranes (n = 74), term in activate labor (n = 84), and term not in labor (n = 21). Fluid was cultured for aerobic and anaerobic bacteria and for Mycoplasma species. Tumor necrosis factor was measured with a commercially available enzyme-linked immunosorbent assay validated for amniotic fluid (sensitivity 60 pg/ml). RESULTS: Amniotic fluid from pregnant women in the second and third trimesters who were not in labor did not contain tumor necrosis factor. Among women in preterm labor, 92.3% ( 12 13) of patients with a positive amniotic fluid culture had detectable tumor necrosis factor in the amniotic fluid (median 820 pg/ml, range <60 to 2340 pg/ml). In contrast, only 10.2% ( 4 39) of women with a negative amniotic fluid culture had detectable tumor necrosis factor. Histopathologic chorioamnionitis was found in all patients who had a positive amniotic fluid culture, and tumor necrosis factor was detectable in the amniotic fluid of all but one of these patients. Among women in active labor at term, 25% ( 21 84) had detectable tumor necrosis factor in the amniotic fluid. Tumor necrosis factor was detected more frequently in the amniotic fluid of patients with a positive amniotic fluid culture than in patients with a negative culture (46.6% [ 7 15] vs 20.2% [ 14 69], p = 0.047). Amniotic fluid concentrations of tumor necrosis factor were significantly higher in patients with preterm premature rupture of membranes, labor, and a positive amniotic fluid culture than in the other subgroups of patients with preterm premature rupture of membranes. CONCLUSION: Parturition in the setting of microbial invasion of the amniotic cavity in associated with activation of the cytokine network as demonstrated by the detection of tumor necrosis factor in human amniotic fluid.

Original languageEnglish
Pages (from-to)1576-1587
Number of pages12
JournalAmerican Journal of Obstetrics and Gynecology
Volume166
Issue number5
DOIs
StatePublished - 1 Jan 1992
Externally publishedYes

Keywords

  • Labor
  • amniotic fluid
  • cytokine
  • immunoassay
  • parturition
  • prematurity
  • preterm labor
  • term labor
  • tumor necrosis factor

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Fingerprint

Dive into the research topics of 'Tumor necrosis factor in preterm and term labor'. Together they form a unique fingerprint.

Cite this