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The objectives of this study were to: (i) examine whether amniotic fluid (<jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>) concentrations of soluble endoglin (sEng), a protein with anti\u2010angiogenic properties, change during pregnancy, parturition, or intra\u2010amniotic infection and\/or inflammation (<jats:styled-content style=\"fixed-case\">IAI<\/jats:styled-content>); (ii) determine whether an increase in sEng in the AF of patients with preterm labor (<jats:styled-content style=\"fixed-case\">PTL<\/jats:styled-content>) and preterm prelabor rupture of membranes (<jats:styled-content style=\"fixed-case\">PROM<\/jats:styled-content>) is associated with adverse neonatal outcomes; and (iii) investigate potential sources of sEng in <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>A cross\u2010sectional study was conducted to include patients in the following groups: (i) mid\u2010trimester (<jats:italic>n<\/jats:italic>\u00a0=\u00a020); (ii) <jats:styled-content style=\"fixed-case\">PTL<\/jats:styled-content> with term delivery (<jats:italic>n<\/jats:italic>\u00a0=\u00a095); (iii) <jats:styled-content style=\"fixed-case\">PTL<\/jats:styled-content> leading to preterm delivery with (<jats:italic>n<\/jats:italic>\u00a0=\u00a040) and without <jats:styled-content style=\"fixed-case\">IAI<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a046); (iv) preterm <jats:styled-content style=\"fixed-case\">PROM<\/jats:styled-content> with (<jats:italic>n<\/jats:italic>\u00a0=\u00a037) and without <jats:styled-content style=\"fixed-case\">IAI<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a037); (v) term in labor (<jats:italic>n<\/jats:italic>\u00a0=\u00a048) and not in labor (<jats:italic>n<\/jats:italic>\u00a0=\u00a044). <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> concentrations of sEng were determined by enzyme\u2010linked immunosorbent assay. Chorioamniotic membranes, umbilical cord blood, and <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> macrophages were examined for the expression of endoglin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>(i) Patients with <jats:styled-content style=\"fixed-case\">IAI<\/jats:styled-content> had a higher median <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> concentration of sEng than those without <jats:styled-content style=\"fixed-case\">IAI<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.02 for <jats:styled-content style=\"fixed-case\">PTL<\/jats:styled-content> and 0.06 for preterm <jats:styled-content style=\"fixed-case\">PROM<\/jats:styled-content>); (ii) <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> concentrations of <jats:styled-content style=\"fixed-case\">sE<\/jats:styled-content>ng in the 3rd and 4th quartiles were associated with <jats:styled-content style=\"fixed-case\">IAI<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.5 and 7.9, respectively); (iii) an <jats:styled-content style=\"fixed-case\">AF sE<\/jats:styled-content>ng concentration \u2265779.5\u00a0pg\/mL was associated with bronchopulmonary dysplasia (BPD) (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 7.9); (iv) endoglin was co\u2010localized with CD14+ macrophages in <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> pellets of patients with <jats:styled-content style=\"fixed-case\">IAI<\/jats:styled-content> by immunofluorescence and flow cytometry; and (v) the concentration of <jats:styled-content style=\"fixed-case\">sE<\/jats:styled-content>ng in the supernatant was significantly increased after the treatment of macrophages with endotoxin or <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u2010\u03b1.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Soluble endoglin participates in the host response against <jats:styled-content style=\"fixed-case\">IAI<\/jats:styled-content>. Activated macrophages may be a source of sEng concentrations in the <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> of patients with <jats:styled-content style=\"fixed-case\">IAI<\/jats:styled-content>. An increase of <jats:styled-content style=\"fixed-case\">sE<\/jats:styled-content>ng in the <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> is associated with <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content> and adverse neonatal outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aji.12046","type":"journal-article","created":{"date-parts":[[2012,12,24]],"date-time":"2012-12-24T07:23:28Z","timestamp":1356333808000},"page":"105-123","source":"Crossref","is-referenced-by-count":22,"title":["Endoglin in Amniotic Fluid as a Risk Factor for the Subsequent Development of Bronchopulmonary Dysplasia"],"prefix":"10.1111","volume":"69","author":[{"given":"Sun K.","family":"Kim","sequence":"first","affiliation":[{"name":"Perinatology Research Branch NICHD\/NIH\/DHHS Bethesda MD and Detroit, MI USA"},{"name":"Department of Obstetrics and Gynecology Wayne State University School of Medicine Detroit MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Romero","sequence":"additional","affiliation":[{"name":"Perinatology Research Branch NICHD\/NIH\/DHHS Bethesda MD and Detroit, MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeynep A.","family":"Savasan","sequence":"additional","affiliation":[{"name":"Perinatology Research Branch NICHD\/NIH\/DHHS Bethesda MD and Detroit, MI USA"},{"name":"Department of Obstetrics and Gynecology Wayne State University School of Medicine Detroit MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Xu","sequence":"additional","affiliation":[{"name":"Perinatology Research Branch NICHD\/NIH\/DHHS Bethesda MD and Detroit, MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhong","family":"Dong","sequence":"additional","affiliation":[{"name":"Perinatology Research Branch NICHD\/NIH\/DHHS Bethesda MD and Detroit, MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deug\u2010Chan","family":"Lee","sequence":"additional","affiliation":[{"name":"Perinatology Research Branch NICHD\/NIH\/DHHS Bethesda MD and Detroit, MI USA"},{"name":"Department of Medical Biotechnology College of Biomedical Science Kangwon National University Chunchon Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lami","family":"Yeo","sequence":"additional","affiliation":[{"name":"Perinatology Research Branch NICHD\/NIH\/DHHS Bethesda MD and Detroit, MI USA"},{"name":"Department of Obstetrics and Gynecology Wayne State University School of Medicine Detroit MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia S.","family":"Hassan","sequence":"additional","affiliation":[{"name":"Perinatology Research Branch NICHD\/NIH\/DHHS Bethesda MD and Detroit, MI USA"},{"name":"Department of Obstetrics and Gynecology Wayne State University School of Medicine Detroit MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tinnakorn","family":"Chaiworapongsa","sequence":"additional","affiliation":[{"name":"Perinatology Research Branch NICHD\/NIH\/DHHS Bethesda MD and Detroit, MI USA"},{"name":"Department of Obstetrics and Gynecology Wayne State University School of Medicine Detroit MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,12,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1994.tb21771.x"},{"key":"e_1_2_8_3_1","first-page":"28","volume-title":"Preterm birth","author":"Romero R","year":"2004"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767050600965882"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-7-S1-S2"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e31811ebef6"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2010.05657.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-2959"},{"key":"e_1_2_8_9_1","first-page":"1","article-title":"Births: final data for 2009","volume":"60","author":"Martin JA","year":"2011","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_8_10_1","first-page":"362","article-title":"Neonatal pediatrics. 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