Preterm labor is characterized by a high abundance of amniotic fluid prostaglandins in patients with intra-amniotic infection or sterile intra-amniotic inflammation

To distinguish between prostaglandin and prostamide concentrations in the amniotic fluid of women who had an episode of preterm labor with intact membranes through the utilisation of liquid chromatography-tandem mass spectrometry. Liquid chromatography-tandem mass spectrometry analysis of amniotic fluid of women with preterm labor and (1) subsequent delivery at term (2) preterm delivery without intra-amniotic inflammation; (3) preterm delivery with sterile intra-amniotic inflammation (interleukin (IL)-6>2.6 ng/mL without detectable microorganisms); and (4) preterm delivery with intra-amniotic infection [IL-6>2.6 ng/mL with detectable microorganisms]. (1) amniotic fluid concentrations of PGE₂, PGF_2α, and PGFM were higher in patients with intra-amniotic infection than in those without intra-amniotic inflammation; (2) PGE₂ and PGF_2α concentrations were also greater in patients with intra-amniotic infection than in those with sterile intra-amniotic inflammation; (3) patients with sterile intra-amniotic inflammation had higher amniotic fluid concentrations of PGE₂ and PGFM than those without intra-amniotic inflammation who delivered at term; (4) PGFM concentrations were also greater in women with sterile intra-amniotic inflammation than in those without intra-amniotic inflammation who delivered preterm; (5) amniotic fluid concentrations of prostamides (PGE₂-EA and PGF_2α-EA) were not different among patients with preterm labor; (6) amniotic fluid concentrations of prostaglandins, but no prostamides, were higher in cases with intra-amniotic inflammation; and (7) the PGE₂:PGE₂-EA and PGF_2α:PGF_2α-EA ratios were higher in patients with intra-amniotic infection compared to those without inflammation. Mass spectrometric analysis of amniotic fluid indicated that amniotic fluid concentrations of prostaglandins, but no prostamides, were higher in women with preterm labor and intra-amniotic infection than in other patients with an episode of preterm labor. Yet, women with intra-amniotic infection had greater amniotic fluid concentrations of PGE₂ and PGF_2α than those with sterile intra-amniotic inflammation, suggesting that these two clinical conditions may be differentiated by using mass spectrometric analysis of amniotic fluid.

本数据集旨在通过液相色谱-串联质谱法（liquid chromatography-tandem mass spectrometry），鉴别胎膜完整的早产发作女性羊水内前列腺素（prostaglandin）与前列腺酰胺（prostamide）的浓度差异。本研究对该类早产孕妇的羊水开展液相色谱-串联质谱分析，按临床结局将其分为4组：(1) 足月分娩组；(2) 无羊膜腔内炎症的早产分娩组；(3) 伴无菌性羊膜腔内炎症的早产分娩组[白细胞介素（interleukin, IL）-6＞2.6 ng/mL且未检出微生物]；(4) 伴羊膜腔内感染的早产分娩组[IL-6＞2.6 ng/mL且检出微生物]。分析结果显示：(1) 羊膜腔内感染患者的羊水前列腺素E₂（PGE₂）、前列腺素F₂α（PGF₂α）及前列腺素F代谢物（PGFM）浓度均高于无羊膜腔内炎症者；(2) 羊膜腔内感染患者的PGE₂与PGF₂α浓度亦高于无菌性羊膜腔内炎症患者；(3) 无菌性羊膜腔内炎症患者的羊水PGE₂与PGFM浓度，高于足月分娩且无羊膜腔内炎症者；(4) 无菌性羊膜腔内炎症患者的羊水PGFM浓度，亦高于早产分娩且无羊膜腔内炎症者；(5) 早产发作患者的羊水前列腺酰胺（PGE₂-EA与PGF₂α-EA）浓度无组间差异；(6) 伴羊膜腔内炎症者的羊水前列腺素浓度更高，而前列腺酰胺浓度无此差异；(7) 与无炎症者相比，羊膜腔内感染患者的PGE₂:PGE₂-EA及PGF₂α:PGF₂α-EA比值更高。羊水质谱分析结果进一步显示，相较于其他早产发作患者，伴羊膜腔内感染与早产的女性羊水前列腺素浓度更高，而前列腺酰胺浓度无此差异。此外，羊膜腔内感染患者的羊水PGE₂与PGF₂α浓度高于无菌性羊膜腔内炎症患者，提示可通过羊水质谱分析鉴别这两种临床情况。