SMFM 27th Annual Meeting 2007
view the interview video: Proteomics of the Amniotic Fluid to Predict Preterm Birth
Objective: Identification of relevant disease biomarkers that may impact prediction of preterm birth (PTB) and fetal outcome is critical. Recent advancement in proteomics has provided a valuable perspective related to several complex functional and molecular mechanisms (inflammation, bleeding) leading to PTB. Still, the etiology of most PTB remains elusive. A comprehensive analysis of the amniotic fluid (AF) proteome was conducted to identify disease biomarker patterns related to PTB in the absence of infection/inflammation or bleeding.
Study Design: A proteomic fingerprint was generated from fresh AF using SELDI-TOF mass spectrometry in a total of 268 consecutive samples retrieved from women who presented with signs or symptoms of preterm labor or PPROM. Intra-amniotic inflammation and bleeding were excluded based on previously validated proteomic profiles and biomarker identification. Hierarchical clustering algorithms based on novel descriptors quantifying similarity/dissimilarity among tracings allowed identification of mass areas of interest.
Results: The prevalence of PTB <34 wks was 77%. A novel discriminatory profile was identified in the 10-14 kDa area of interest and consisted of 5 proteomic peaks (Q1-5; Figure). The abnormal profile was associated with PTB in the absence of intra-amniotic infection, inflammation or bleeding. Women displaying the novel profile were at 27.1 [16.3-36.1] wks GA at amniocentesis and most often presented with intact membranes. The novel profile appeared alone and all other tests of AF were normal in 85% (17/20) of cases.
Conclusion: Proteomic profiling of the AF coupled with novel mathematical algorithms can be used to identify patients at risk for PTB in the absence of intra-amniotic inflammation or bleeding.
0002-9378/$ - see front matter
American Journal of Obstetrics and Gynecology
Volume 195, Issue 6, Supplement S (December 2006)