Vaginal matrix metalloproteinase-9 (MMP-9) as a potential early predictor of preterm birth.
J Perinat Med
; 52(6): 591-596, 2024 Jul 26.
Article
in En
| MEDLINE
| ID: mdl-38785035
ABSTRACT
OBJECTIVES:
To evaluate the differences in vaginal matrix metalloproteinases (MMP) and tissue inhibitors of metalloproteinases (TIMPs) in pregnant patients with a history of prior preterm birth compared with controls.METHODS:
A prospective cohort pilot study recruited patients during prenatal care with history of prior spontaneous preterm birth (high-risk group) or no history of preterm birth (low-risk/controls). Inclusion criteria were singleton gestation at 11-16 weeks and between 18 and 55 years of age. Exclusion criteria were diabetes mellitus, hypertension, diseases affecting the immune response or acute vaginitis. A vaginal wash was performed at time of enrollment, and patients were followed through delivery. Samples were analyzed using semi-quantitative analysis of MMPS and TIMPS. The study was approved by the IRB and a p-value <0.05 was considered significant.RESULTS:
A total of 48 pregnant patients were recruited 16 with a history of preterm birth (high-risk group) and 32 with no history of preterm birth (low-risk group/controls). Groups were similar in age, race, BMI, and delivery mode. The high-risk group had more multiparous women (100 vs. 68.8â¯%; p=0.02), a greater preterm birth rate (31.2 vs. 6.3â¯%; p=0.02), and a lower birth weight (2,885 ± 898â¯g vs. 3,480 ± 473â¯g; p=0.02). Levels of vaginal MMP-9 were greater in high-risk patients than low-risk patients (74.9â¯% ± 27.0 vs. 49.4â¯% ± 31.1; p=0.01). When dividing the cohort into patients that had a spontaneous preterm birth (7/48, 14.6â¯%) vs. those with a term delivery (41/48, 85.4â¯%), the vaginal MMP-9 remained elevated in the cohort that experienced a preterm birth (85.46â¯%+19.79 vs. 53.20â¯%+31.47; p=0.01). There were no differences in the other MMPS and in TIMPs between high and low-risk groups.CONCLUSIONS:
There was an increase in vaginal MMP-9 during early pregnancy in those at high risk for preterm birth and in those who delivered preterm, regardless of prior pregnancy outcome. Vaginal MMP-9 may have potential as a marker of increased risk of preterm birth.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Vagina
/
Matrix Metalloproteinase 9
/
Premature Birth
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Newborn
/
Pregnancy
Language:
En
Journal:
J Perinat Med
Year:
2024
Document type:
Article
Affiliation country:
Estados Unidos
Publication country:
ALEMANHA
/
ALEMANIA
/
DE
/
DEUSTCHLAND
/
GERMANY