Heparin-binding Proteins in Amniotic Fluid: Predicter for Histological Chorioamnionitis?

Abstract Background: Histological chorioamnionitis (HCA) is a serious threat to fetal health during pregnancy, which is not easily detected due to the lack of clinical symptoms, and there is still a lack of effective predictors and diagnostic indicators. Heparin-binding protein (HBP), an antimicrobial protein secreted by neutrophils, is highly valuable in predicting a variety of infectious diseases and is expected to be an effective predictor of histological chorioamnionitis.Methods: A total of 100 full-term healthy pregnant women delivered by cesarean section (control group) and 51 randomly enrolled pregnant women (pathology group) were included in this study. Amniotic fluid was extracted at delivery for HBP concentration, and postpartum placental pathology was performed in the pathology group to clarify the diagnosis of HCA. The predictive value of HBP in amniotic fluid for HCA was determined by establishing the reference interval for HBP in normal population and the receiver operating characteristic (ROC) curve.Results: The 95% confidence interval (95% CI) for HBP concentration in the amniotic fluid of normal pregnant women was 0- 87.08 ng/ml, with a median of 6.41 ng/ml; HBP concentration in the amniotic fluid of pregnant women with HCA was significantly higher than that of controls (P < 0.001) and non-HCA pregnant women (P < 0.001). The ROC curve showed that when the cut-off value of HBP in amniotic fluid was 82.67 ng/ml, the corresponding sensitivity, specificity, positive predictive value, negative predictive value and area under the curve (AUC) were 84.20%, 96.90%, 94.12%, 91.18% and 0.86 (P < 0.001, 95% CI 0.715-1.000), respectively. Discussion: HBP in amniotic fluid is a potential, good predictor of HCA. We will further to explore its clinical application value.