Objective:

This study aimed to investigate the role of various biochemical markers in preterm premature rupture of membranes (PPROM) and in prediction of chorioamnionitis in patients with PPROM.

Material and Methods:

This case-control study included a total of 100 pregnant women at 26-34 gestational weeks. Of these women, 50 were healthy and 50 had PPROM. The biochemical markers in the maternal plasma including prolidase, matrix metalloproteinase (MMP) 1 and 13, total oxidative status (TOS), total antioxidant capacity (TAC), glutathione peroxidase (GPx), catalase (CAT), paraoxonase-1 (PON-1), tumor necrosis factor alpha (TNF-α), and high sensitive C-reactive protein (hs- CRP) were assayed. These levels were compared between the PPROM and control groups and between women with or without chorioamnionitis in the PPROM group.

Results:

Compared to the control group, the levels of prolidase, MMP- 13, and TOS were significantly higher (p values <0.001, 0.020, and 0.035, respectively) and those of TAC and PON-1 were significantly lower in the maternal plasma of the PPROM group (p values=0.012 and <0.001, respectively). The plasma prolidase and TOS levels were significantly higher (p values=0.033 and 0.005, respectively) and the plasma TAC and PON-1 levels were significantly lower in women with chorioamnionitis as compared with the corresponding values in women without chorioamnionitis in the PPROM group (p values =0.041 and 0.048, respectively). The multivariate logistic regression analysis observed that prolidase, TAC, and PON-1 were important markers for the presence of PPROM and prolidase and TOS were important markers for predicting chorioamnionitis.

Conclusion:

This study suggested that maternal plasma prolidase, TAC, and PON-1 may be useful for the diagnosis of PPROM, and prolidase and TOS may be used to predict chorioamnionitis in patients with PPROM.

Keywords: Preterm premature rupture of membranes, maternal plasma, prolidase, matrix metalloproteinase, oxidative stress