433. Identifying novel biomarkers predictive of impending human labour
Y. J. Heng A B , M. K. W. Di Quinzio A B , M. Permezel A B , G. E. Rice A B C and H. M. Georgiou A BA Obstetrics & Gynaecology, University of Melbourne, Melbourne, Vic., Australia.
B Mercy Perinatal Research Centre, Mercy Hospital for Women, Heidelberg, Vic., Australia.
C Translational Proteomics, Baker Heart Research Institute, Melbourne, Vic., Australia.
Reproduction, Fertility and Development 20(9) 113-113 https://doi.org/10.1071/SRB08Abs433
Published: 28 August 2008
Abstract
Human labour is characterised by structural remodelling of the cervix and overlying fetal membranes, myometrial activation and parturition. We hypothesise that temporal biochemical alterations of the cervix and supracervical fetal membranes associated with impending labour may be reflected in the cervico-vaginal fluid (CVF). 2D PAGE proteomic analysis performed on serial CVF samples collected from women (n = 9) during late pregnancy and in spontaneous labour demonstrated 9 significantly altered protein spots (P < 0.05) in association with term labour. Seven different proteins were identified using electrospray ion-trap mass spectrometry (interleukin-1 receptor antagonist (IL-1ra), cystatin-A, glutathione S-transferase P, peroxiredoxin-2, thioredoxin, Cu,Zn superoxide dismutase, and epidermal fatty-acid binding protein). These proteins are involved in anti-inflammatory activity, protease inhibition, and oxidative stress defence. Validation of these potential biomarkers using ELISA is currently underway. Findings for the anti-inflammatory cytokine, IL-1ra are discussed. CVF was collected weekly from 106 women at 36 weeks' gestation up to and including spontaneous labour. The concentration of IL-1ra was 4-fold lower during labour compared with 15–21 and 22–28 days from labour (P < 0.05) and was also significantly lower (P < 0.05) at 0–7 days compared with 15–21 days before labour. After subdividing the women, the concentration of IL-1ra at 8–14 and 15–21 days before labour was 6-fold lower in women who had prelabour rupture of membranes at term followed by regular contractions compared with women who had spontaneous labour with intact membranes. Receiver-operator characteristic curve analysis indicated that IL-1ra best predicted term labour within 3 days of sampling with a cut-off value of 0.4 m g/mL (sensitivity 50.7%, specificity 72.2%, positive predictive value 36.1%, negative predictive value 82.6%). This IL-1ra validation study suggests that the decrease in IL-1ra in CVF during spontaneous term labour may be associated with proinflammatory-mediated remodelling of the fetal membranes leading to their rupture.
(1) Di Quinzio et al. 2008, J. Proteome Res, 7:1916–1921.
(2) Heng YJ et al. 2008, Am J Obstet Gynecol, In Press.
