Matrix metalloproteinase-1 and-9 in cervicovaginal fluid from women duringpregnancy and in labor

Objective We sought to determine whether cervicovaginal fluid matrix metall oproteinase-l and -9 (MMP-1 and MMP-9) levels differed during pregnancy com pared with those at term or in preterm labor. Study design We used sensitive immunoassays to measure MMP-1 and MMP-9 leve ls in cervicovaginal secretions. Cases (n = 32) included women who delivere d preterm, and were sampled more than 3 weeks prior to delivery (n = 19), w ithin 1 week of delivery (n = 7), and during spontaneous labor (n = 6). Con trols consisted of 80 women matched for race, age and gestational age, deli vering at term and who were sampled at 20-32 weeks (n = 47), within I week of delivery (n = 14) and during term labor (n = 19). Results Among cases and controls, cervicovaginal MMP-1 levels were low and unaffected by labor. Among non-laboring control patients, the median and ra nge of MMP-9 concentrations were also low (0; 0-0.04 ng/ml), and these rema ined unchanged with advancing gestational age. However, MMP-9 levels increa sed significantly within 1 week of term labor (0.8; 0-22.8 ng/ml; p = 0.001 ) and during term labor (6.6; 0-30.6 ng/ml; p = 0.04), with the highest val ues observed among laboring patients with ruptured membranes (24.8; 19.2-30 .6 ng/ml; p = 0.002). Among cases, MMP-9 concentrations were unaltered prio r to preterm labor, but increased among patients in preterm labor (0.3; 0-3 0 ng/ml; p = 0.02). Conclusion Cervicovaginal MMP-1 levels were low and unchanged during either preterm or term labor. In contrast, MMP-9 levels increased during term and preterm labor but did not predict preterm delivery in asymptomatic patient s.