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Basic Science

Poster Session 1

(161) Amniotic fluid sCD14, presepsin (sCD14-ST), intraamniotic infection/inflammation and early onset neonatal sepsis (EONS)

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

    Primary & Presenting Author(s)

  • Michelle Firlit, MD

    MFM Fellow
    University of Illinois at Chicago
    Chicago, IL, United States

    • Coauthor(s)

  • GZ

    Guomao Zhao, BS

    Laboratory Manager, Perinatal Research
    University of Illinois at Chicago
    Chicago, IL, United States

  • IB

    Irina A. Buhimschi, MD

    Professor and Director, Perinatal Research
    University of Illinois at Chicago
    Chicago, IL, United States

  • MB

    Mert Ozan Bahtyiar, MD

    Yale University
    New Haven, CT, United States

  • Catalin S. Buhimschi, MBA, MD

    Professor and Division Director Maternal Fetal Medicine
    University of Illinois at Chicago
    Chicago, IL, United States

Objective: Soluble CD14 (sCD14) is a monocyte/macrophage activation marker and mediator of bacterial lipopolysaccharide (LPS) action. Presepsin (sCD14-ST) is a cleavage product of sCD14. Elevated cord blood (CB) presepsin were proposed as a biomarker for EONS. We aimed to determine if amniotic fluid (AF) presepsin is elevated in the context of IAI and could serve as a biomarker of EONS.


Study Design: Presepsin and sCD14 were evaluated by ELISA in AF of 29 randomly selected singleton pregnancies who had transabdominal amniocentesis to rule out infection. Pregnancy outcomes were grouped as: 1) preterm birth (PTB) positive IAI (PTB+IAI, n=11, [mean±SE] GA: 26±1 wks]; 2) idiopathic PTB absent IAI [PTB-IAI, n=10, GA: 29±1 wks]; 3) term birth absent IAI [TB-IAI, n=8, GA: 29±1 wks). AF interleukin-6 (IL-6) and matrix metalloprotease-9 (MMP9) levels were measured as indicators of inflammation and proteolytic activity, respectively. Matched CB from fetuses with EONS and maternal blood (MB) samples were analyzed for a subset of PTB groups. We used parametric statistics (1-way ANOVA) after log transformation, correlation and regression analyses.

Results: AF sCD14 was significantly elevated in the context of IAI [PTB+IAI: 1,090±255 ng/mL vs. PTB-IAI: 443±96 ng/mL, ANOVA p=.017; vs. TB-IAI 393±49 ng/mL, p=.013). Generally, presepsin was detectable in AF, at similar levels with MB, but at 10-fold lower than in CB. Following adjustment for GA and membrane status, AF presepsin did not differ among the groups [PTB+IAI: 5.3±1.6 ng/mL vs. PTB-IAI: 3.8±0.6 ng/mL, vs. TB-IAI 5.4±1.4 ng/mL, p >0.05 for all). AF sCD14 was positively correlated with AF IL-6 (r=0.619, p< .001) and AF MMP9 (r=0.714, p< .001) concentrations. There were no significant correlations of AF presepsin with sCD14, IL-6 or MMP-9.

Conclusion: sCD14 is significantly elevated in IAI. Yet, AF may carry inhibitory properties that neutralize cleavage of sCD14, thereby limiting the ability of AF presepsin to be used as biomarker of IAI or EONS.