The Significance Of The P65 Submit Of Nuclear Factor-kappa B, Interleukin-8 And Matrix Metalloproteinase-9 In Maternal Blood In Predicting Preterm Birth With Subclinical Chorioamnionitis

Objective: To study the relativity between the NF-κB P65(the P65 submitof the nuclear factor kappa B), IL-8(interleukin-8) and MMP-9 (matrixmetalloproteinase-9) in maternal blood in preterm birth patients andsubclinical chorioamnionitis, to analyze their effect on the pathogenesisof the preterm birth patients with subclinical chorioamnionitis, then toestimate their clinical value in predicting infective immature labor.Methods: To chose 36 cases of preterm birth patients in labor as trialgroup, 37 cases of full term gravida with inlabor, 38 cases of full termgravida without threatened labor and 18 cases who have the identicalgestational age with preterm birth patients as control groups. To observethe change of NF-κB P65, IL-8 and MMP-9 in maternal blood in everygroup by three methods, which were immunocytochemical staining,enzyme-linked immunosorbent assay and HE staining.Results:1. Subclinical chorioamnionitis preterm birth patients are more than thefull term gravida with inlabor group and the full term gravida withoutthreatened labor group.2. The expression of NF-κB P65, IL-8 and MMP-9 were little changesoccurred in maternal blood in healthy pregnant in late pregnancy.3. The expression of NF-κB P65, IL-8 and MMP-9 were little changesoccurred in maternal blood in healthy pregnant in labor or not.4. The levels of NF-κB P65, IL-8 and MMP-9 in preterm birth withsubclinical chorioamnionitis patients were statistically significantlyhigher than those in preterm birth without chorioamnionitis groups andgroups who have the identical gestational age with preterm birth patients.5. The expression of NF-κB P65, IL-8 and MMP-9 in maternal blood inpreterm birth patients with subclinical chorioamnionitis before pregnantwere statistically significantly higher than those after pregnant. Theexpression of NF-κB P65, IL-8 and MMP-9 in maternal blood inpregnant without chorioamnionitis before pregnant were similar with those after pregnant.6. It's positive correlation among NF-κB P65, IL-8 and MMP-9 inmaternal blood.7. By ROC curve, maternal blood NF-κB P65 levels 2.50, IL-8 levels20.61ng/ml and levels 324.40ng/ml were regarded as the diagnosisthreshold value of subclinical chorioamnionitis. The area under the curvewere 0.927, 0.812 and 0.852, respectively. NF-κB P65 tested by ICC, hadthe best sensitivity, specificity, positive predictive vaue, negativepredictive vaue, Youden's index and percent agreement for diagnosingchorioamnionitis.Conclusion:1. The expression of NF-κB P65, IL-8 and MMP-9 in maternal blood inpregnant are not influenced by gestational age and labor.2. The expression of NF-κB P65, IL-8 and MMP-9 in maternal blood inpregnant increase obviously in infective preterm labor.3. NF-κB P65 is more reliable indicator of histologic ehorioamnionitisthan IL-8 or MMP-9 in women with preterm birth.