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Elevated Amniotic Fluid Nucleosome Levels in Women With Intra-amniotic Infection

From the Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut.

Address reprint requests to: Chaur-Dong Hsu, MD, MPH, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT 06520-8063

Objective: To compare amniotic fluid (AF) soluble nucleo-some levels in pregnant women with and without intra-amniotic infection.

Methods: Amniocentesis was performed in 74 pregnant women with preterm contractions, labor, or premature rupture of membranes. Intra-amniotic infection was defined as a positive AF culture. Amniotic fluid tests for Gram stain, glucose, neutrophils, creatinine, pH, and specific gravity were performed. Amniotic fluid soluble nucleosome levels were determined by enzyme-linked immunosorbent assay and were normalized by AF creatinine levels.

Results: Twenty-eight patients had intra-amniotic infection and 46 did not. Amniotic fluid soluble nucleosome levels were significantly higher in pregnant women with intra-amniotic infection than in those without infection (48.1±21.3 compared with 0.0 ± 0.0 U/mg creatinine; P = .005). The AF nucleosome levels were positively correlated with AF neutrophil counts and negatively correlated with AF glucose concentrations.

Conclusion: Our data indicate that elevated AF nucleo-some levels are associated with intra-amniotic infection and may have potential as a clinical marker to detect intra-amniotic infection.

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