Katerina Lyubomirskaya1, Yuriy Krut1, Lyudmila Sergeyeva2, Stefan Khmil3, Olena Lototska4, Nataliya Petrenko5, Alexandr Kamyshnyi5. 1. Department of Obstetrics and Gynecology, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine. 2. Department of the Medical Physics, Biophysics and Higher Mathematics, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine. 3. Department of Obstetrics and Gynaecology No 1, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine. 4. Department of Obstetrics and Gynaecology No 2, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine. 5. Department of Microbiology, Virology and Immunology, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine.
Abstract
The etiology of preterm premature rupture of membranes (PPROM), which is responsible for approximately 30% cases of preterm birth (PTB) is not yet fully understood. AIM: The aim of the study was to create a mathematical model for prognostication of PPROM based on the anamnesis, clinical data, laboratory findings and genetics predictors. MATERIALS AND METHODS: The study involved 80 women with PPROM (between 26 and 34 weeks of gestation) and 50 women having term birth (>37 weeks of gestation) of Zaporizhzhia region of Ukraine. Anamnesis, clinical, laboratory data and single nucleotide polymorphism sequencing of interleukin1 β (IL1β), tumor necrosis factor α(TNFα), interleukin4 (IL4), interleukin10 (IL10) and Relaxin 2 (RLN2) genes has been analyzed. Receiver operating characteristic analysis and multivariate logistic regression were used to PPROM predictors identification. RESULTS: We have identified prognostic anamnestic (history of preterm birth), clinical (cervical insuffiency, compromised uteroplacental and fetal circulation), microbiological (vaginal dysbiosis) and hematological criteria for intra-amniotic contamination and further development of PPROM and PTB: WBC>12.3×109/L, GRAN>76%, LYM<19%, neutrophil lymphocyte ratio>3.87, Kalph-Kaliph leukocyte index of intoxication (LII) >3.4, Ostrovsky LII >2.8. Also we have found that GG genotype of IL10 gene polymorphism (rs1800872) leads to a 12.5-fold and CT genotype of RLN2 gene polymorphism (rs4742076) leads to a 17.0-fold increase in risk for PPROM. CONCLUSIONS: The prognostic model that we have suggested is an adequate and convenient instrument for practical medical use, which allows for assessment of PPROM probability with a 85% sensitivity and a 72% specificity.
The etiology of preterm premature rupture of membranes (PPROM), which is responsible for approximately 30% cases of preterm birth (PTB) is not yet fully understood. AIM: The aim of the study was to create a mathematical model for prognostication of PPROM based on the anamnesis, clinical data, laboratory findings and genetics predictors. MATERIALS AND METHODS: The study involved 80 women with PPROM (between 26 and 34 weeks of gestation) and 50 women having term birth (>37 weeks of gestation) of Zaporizhzhia region of Ukraine. Anamnesis, clinical, laboratory data and single nucleotide polymorphism sequencing of interleukin1 β (IL1β), tumor necrosis factor α(TNFα), interleukin4 (IL4), interleukin10 (IL10) and Relaxin 2 (RLN2) genes has been analyzed. Receiver operating characteristic analysis and multivariate logistic regression were used to PPROM predictors identification. RESULTS: We have identified prognostic anamnestic (history of preterm birth), clinical (cervical insuffiency, compromised uteroplacental and fetal circulation), microbiological (vaginal dysbiosis) and hematological criteria for intra-amniotic contamination and further development of PPROM and PTB: WBC>12.3×109/L, GRAN>76%, LYM<19%, neutrophil lymphocyte ratio>3.87, Kalph-Kaliph leukocyte index of intoxication (LII) >3.4, Ostrovsky LII >2.8. Also we have found that GG genotype of IL10 gene polymorphism (rs1800872) leads to a 12.5-fold and CT genotype of RLN2 gene polymorphism (rs4742076) leads to a 17.0-fold increase in risk for PPROM. CONCLUSIONS: The prognostic model that we have suggested is an adequate and convenient instrument for practical medical use, which allows for assessment of PPROM probability with a 85% sensitivity and a 72% specificity.
Authors: Iryna Ivanivna Kamyshna; Larysa Borysivna Pavlovych; Igor Volodymyrovych Malyk; Aleksandr Mychailovich Kamyshnyi Journal: J Med Life Date: 2021 Jul-Aug