Study On The Correlation Between MMP-3,MMP-9,SAA And Premature Rupture Of Membranes And Its Relationship With Pregnancy Outcome

Objective(s): To analyze the correlation between matrix metalloproteinase-3(MMP-3),matrix metalloproteinase-9(MMP-9),serum amyloid A(SAA),white blood cell count(WBC),neutrophil percentage(NEUT%),platelet(PLT)and premature rupture of membranes(PROM),and to explore the predictive value of these indicators in early intrauterine infection and adverse pregnancy outcomes.Methods: 1.Collect serum samples from 101 pregnant women with premature rupture of membranes and normal pregnancy,including 35 cases in the premature rupture of membranes group,30 cases in the premature rupture of membranes group,and 36 cases in the normal pregnancy group(control group).Based on clinical manifestations and placental examination results,determine whether there is clinical chorioamnionitis and histological chorioamnionitis.2.Double antibody sandwich enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of MMP-3,MMP-9,and SAA.Clinical data related to blood routine and adverse pregnancy outcomes(early neonatal bacterial infection,neonatal pneumonia,neonatal sepsis,neonatal asphyxia,postpartum hemorrhage)of the experimental subjects were collected.Results: There was no statistically significant difference in age,admission temperature,gestational frequency,and parity among pregnant women in the PPROM group,TPROM group,and control group(P>0.05);2.The peripheral blood levels of MMP-3,MMP-9,SAA,and WBC in PPROM and TPROM groups were higher than those in the control group(P<0.05).After pairwise comparison,the peripheral blood levels of SAA,NEUT%,and PL T in PPROM group were higher than those in TPROM group(P<0.05),but there was no significant difference between TPROM group and control group(P>0.05).There was no significant difference in peripheral blood levels of MMP-3,MMP-9,and WBC between PPROM and TPROM groups(P>0.05);3.The serum levels of MMP-3,MMP-9,and PL T in pregnant women had no statistically significant impact on the occurrence of premature rupture of membranes(P>0.05).The levels of SAA(OR=1.169,P<0.001),WBC(OR=1.329,P<0.001),and NEUT%(OR=1.076,P=0.011)were correlated with premature rupture of membranes.Multivariate logistic regression analysis found that SAA(OR=1.149,P=0.04)is an independent risk factor for the occurrence of premature rupture of membranes;4.The placental pathological results of pregnant women in the PPROM group,3TPROM group,and control group showed a positive rate of histological chorioamnionitis in PPROM>TPROM>control group(P<0.05);5.The peripheral blood NEUT% and PLT levels in the group of premature rupture of membranes with histological chorioamnionitis were higher than those in the group of premature rupture of membranes without chorioamnionitis(P<0.05).However,there was no statistically significant difference in peripheral blood MMP-3,MMP-9,SAA,and WBC between the group of premature rupture of membranes with histological chorioamnionitis and the group of premature rupture of membranes without histological chorioamnionitis(P>0.05);5.The serum levels of MMP-3,MMP-9,SAA,WBC,NEUT%,and PLT in pregnant women were not significantly different in PPROM group,TPROM combination,and histological chorioamnionitis compared to PPROM group and TPROM group(P>0.05);6.The serum levels of MMP-3,MMP-9,SAA,WBC,NEUT%,and PLT in pregnant women with premature rupture of membranes without adverse pregnancy outcomes were lower than those in the group with adverse pregnancy outcomes,but only PLT showed statistical differences between the two groups(P<0.05);7.There was no statistically significant difference(P>0.05)in the serum levels of MMP-9,WBC,NEUT%,and PLT between the group with adverse pregnancy outcomes and the group without adverse pregnancy outcomes.The serum levels of MMP-3 and SAA in the group with adverse pregnancy outcomes were higher than those in the group without adverse pregnancy outcomes(P<0.05);There was no statistically significant difference in the serum levels of MMP-3,MMP-9,SAA,WBC,NEUT%,and PLT between the PPROM group with adverse pregnancy outcomes and the PPROM group without adverse pregnancy outcomes(P>0.05).Conclusion(s):1.Early intrauterine infection may be one of the main causes of PPROM;2.The increase in SAA may be related to early PPROM infection;3.MMP-3,SAA are sensitive indicators for early detection of intrauterine infections,and the combination of premature rupture of membranes and elevated levels of MMP-3,SAA may indicate an increased likelihood of adverse pregnancy outcomes.