AMNIOTIC-FLUID DEFENSINS - POTENTIAL MARKERS OF SUBCLINICAL INTRAUTERINE INFECTION

Human neutrophil peptides 1-3 (defensins) are granule constituents rel eased from activated neutrophils, We hypothesized that amniotic fluid (AF) defensin levels are elevated in preterm labor (PTL) patients with subclinical intrauterine infection (IUI). AF samples were obtained fr om 203 pregnant patients with varying clinical characteristics. Defens in levels were measured by enzyme-linked immunosorbent assay. Median A F defensin levels were fourfold to 24-fold higher in patients with IUI than in preterm and term controls. Among patients with subclinical IU I, the degree of AF defensin elevation aas greater in those with a pos itive AF culture. AF defensin levels increased exponentially with incr easing severity of histologic chorioamnionitis. An AF defensin level o f >2,500 ng/mL identified 88% of patients with a positive AF culture, whereas a lever of >400 ng/mL identified 85% of all infected patients. AF defensin levels accurately identify patients with subclinical IUI, as defined by a positive AF culture or placental histology.