Geburtshilfe Frauenheilkd 2016; 76 - P544
DOI: 10.1055/s-0036-1593221

Serum concentrations of soluble B7-H4 in early pregnancy are elevated in women with preterm premature rupture of membranes

P Mach 1, A Köninger 1, L Wicherek 2, R Kimmig 1, S Kasimir-Bauer 1, C Birdir 1, B Schmidt 3, A Gellhaus 1
  • 1Uniklinikum Essen, Frauenklinik, Essen, Deutschland
  • 2Department of Gynecology and Oncology, Nicolaus Copernicus University, Bydgoszcz, Polen
  • 3Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University of Duisburg-Essen, Essen, Deutschland

Aim of the study: An adequate immune tolerance plays a key role in successful pregnancy. B7-H4 are co-stimulatory molecules, responsible for the negative regulation of T-cell-mediated immune responses. We analyzed soluble B7-H4 (sB7-H4) serum levels and its association with (preterm) premature rupture of membranes (pPROM).

Method of study: Maternal sB7-H4 were determined with ELISA (BIOZOL, Eching, Germany) in 66 patients between 11 – 13 weeks' gestation who developed pPROM < 370/7 weeks' gestation (n = 21), PROM at term (n = 18) and in control group (n = 27).

Results: Substantially higher sB7-H4 blood serum concentration levels were found in patients who developed pPROM compared to patients who delivered at term with PROM and controls. An OR of 1.39 (95%-CI: 1.17 – 1.77; p = 0.002) per ng/mL sB7-H4 was observed, indicating an increased risk for developing pPROM later on in pregnancy. The AUC estimate of 0.81 indicated that sB7-H4 had some predictive ability to discriminate between pPROM cases and controls.

Abb. 1

Tab. 1: Results of the ROC analysis

Outcome

AUC (95% CI)

Threshold

Specificity (%)

Sensitivity (%)

pPROM

0.81 (0.66, 0.93)

12.1 ng/mL

96.3

61.9

Conclusion: sB7-H4 is a crucial factor in modulation of the immune system activity during pregnancy. Women with increased sB7-H4-levels in the first trimester of pregnancy may be at elevated risk to develop pPROM.