{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T14:56:03Z","timestamp":1781794563576,"version":"3.54.5"},"reference-count":21,"publisher":"Walter de Gruyter GmbH","issue":"2","license":[{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Actim Oy"},{"DOI":"10.13039\/501100009066","name":"Instituto Carlos Slim de la Salud","doi-asserted-by":"publisher","award":["PI19\/00580"],"award-info":[{"award-number":["PI19\/00580"]}],"id":[{"id":"10.13039\/501100009066","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009066","name":"Instituto Carlos Slim de la Salud","doi-asserted-by":"publisher","award":["PI22\/00669"],"award-info":[{"award-number":["PI22\/00669"]}],"id":[{"id":"10.13039\/501100009066","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpm-2023-0405_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Among patients with preterm labor and intact membranes (PTL), those with intra-amniotic infection (IAI) present the highest risk of adverse perinatal outcomes. Current identification of IAI, based on microbiological cultures and\/or polymerase chain reaction amplification of the 16S ribosomal RNA gene, delay diagnosis and, consequently, antenatal management. The aim to of the study was to assess the performance of a multivariable prediction model for diagnosing IAI in patients with PTL below 34.0\u00a0weeks using clinical, sonographic and biochemical biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2023-0405_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From 2019 to 2022, we prospectively included pregnant patients admitted below 34.0\u00a0weeks with diagnosis of PTL and had undergone amniocentesis to rule in\/out IAI. The main outcome was IAI, defined by a positive culture and\/or 16S ribosomal RNA gene in amniotic fluid. Based on the date of admission, the sample (n=98) was divided into a derivation (2019\u20132020, n=49) and validation cohort (2021\u20132022, n=49). Logistic regression models were developed for the outcomes evaluated. As predictive variables we explored ultrasound cervical length measurement at admission, maternal C-reactive protein, gestational age, and amniotic fluid glucose and matrix metalloproteinase-8 (MMP-8) levels. The model was developed in the derivation cohort and applied to the validation cohort and diagnostic performance was evaluated. Clinical management was blinded to the model results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2023-0405_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the study period, we included 98 patients admitted with a diagnosis of PTL. Of these, 10\u202f% had IAI. The final model included MMP-8 and amniotic fluid glucose levels and showed an area under the receiver operating characteristic curve to predict the risk of IAI of 0.961 (95\u202f% confidence interval: 0.860\u20130.995) with a sensitivity of 75\u202f%, specificity of 93.3\u202f%, positive likelihood ratio (LR) of 11.3 and negative LR of 0.27 in the validation cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2023-0405_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with PTL, a multivariable prediction model including amniotic fluid MMP-8 and glucose levels might help in the clinical management of patients undergoing amniocentesis to rule in\/out IAI, providing results within a few minutes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpm-2023-0405","type":"journal-article","created":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T10:14:14Z","timestamp":1702548854000},"page":"136-142","source":"Crossref","is-referenced-by-count":4,"title":["A multivariable prediction model for intra-amniotic infection in patients with preterm labor and intact membranes including a point of care system that measures amniotic fluid MMP-8"],"prefix":"10.1515","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3130-1829","authenticated-orcid":false,"given":"Teresa","family":"Cobo","sequence":"first","affiliation":[{"name":"BCNatal\u00a0\u2013 Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clinic and Hospital Sant Joan de D\u00e9u), Institut Cl\u00ednic de Ginecolog\u00eda, Obstetr\u00edcia I Neonatolog\u00eda , Fetal i+D Fetal Medicine Research Center , Barcelona , Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi I Sunyer (IDIBAPS) , University of Barcelona , Barcelona , Spain"},{"name":"Center for Biomedical Research on Rare Diseases (CIBER-ER) , Institute of Health Carlos III (ISCIII) , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Ferrero","sequence":"additional","affiliation":[{"name":"BCNatal\u00a0\u2013 Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clinic and Hospital Sant Joan de D\u00e9u), Institut Cl\u00ednic de Ginecolog\u00eda, Obstetr\u00edcia I Neonatolog\u00eda , Fetal i+D Fetal Medicine Research Center , Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Haavisto","sequence":"additional","affiliation":[{"name":"Actim Oy , Espoo , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Luokola","sequence":"additional","affiliation":[{"name":"Actim Oy , Espoo , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana B.","family":"Sanchez-Garcia","sequence":"additional","affiliation":[{"name":"BCNatal\u00a0\u2013 Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clinic and Hospital Sant Joan de D\u00e9u), Institut Cl\u00ednic de Ginecolog\u00eda, Obstetr\u00edcia I Neonatolog\u00eda , Fetal i+D Fetal Medicine Research Center , Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Bosch","sequence":"additional","affiliation":[{"name":"Microbiology Department, Center of Biomedical Diagnostic , Hospital Cl\u00ednic of Barcelona, ISGlobal , Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amadeu","family":"Gen\u00e9","sequence":"additional","affiliation":[{"name":"Microbiology Department , Hospital Sant Joan de D\u00e9u , Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Murillo","sequence":"additional","affiliation":[{"name":"BCNatal\u00a0\u2013 Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clinic and Hospital Sant Joan de D\u00e9u), Institut Cl\u00ednic de Ginecolog\u00eda, Obstetr\u00edcia I Neonatolog\u00eda , Fetal i+D Fetal Medicine Research Center , Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Rueda","sequence":"additional","affiliation":[{"name":"BCNatal\u00a0\u2013 Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clinic and Hospital Sant Joan de D\u00e9u), Institut Cl\u00ednic de Ginecolog\u00eda, Obstetr\u00edcia I Neonatolog\u00eda , Fetal i+D Fetal Medicine Research Center , Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardino","family":"Gonz\u00e1lez-de la Presa","sequence":"additional","affiliation":[{"name":"Core Laboratory , Hospital Cl\u00ednic , Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana","family":"Santamaria","sequence":"additional","affiliation":[{"name":"Core Laboratory , Hospital Cl\u00ednic , Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00falia","family":"Ponce","sequence":"additional","affiliation":[{"name":"BCNatal\u00a0\u2013 Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clinic and Hospital Sant Joan de D\u00e9u), Institut Cl\u00ednic de Ginecolog\u00eda, Obstetr\u00edcia I Neonatolog\u00eda , Fetal i+D Fetal Medicine Research Center , Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Boada","sequence":"additional","affiliation":[{"name":"BCNatal\u00a0\u2013 Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clinic and Hospital Sant Joan de D\u00e9u), Institut Cl\u00ednic de Ginecolog\u00eda, Obstetr\u00edcia I Neonatolog\u00eda , Fetal i+D Fetal Medicine Research Center , Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montse","family":"Palacio","sequence":"additional","affiliation":[{"name":"BCNatal\u00a0\u2013 Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clinic and Hospital Sant Joan de D\u00e9u), Institut Cl\u00ednic de Ginecolog\u00eda, Obstetr\u00edcia I Neonatolog\u00eda , Fetal i+D Fetal Medicine Research Center , Barcelona , Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi I Sunyer (IDIBAPS) , University of Barcelona , Barcelona , Spain"},{"name":"Center for Biomedical Research on Rare Diseases (CIBER-ER) , Institute of Health Carlos III (ISCIII) , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"key":"2026061814321982402_j_jpm-2023-0405_ref_001","doi-asserted-by":"crossref","unstructured":"Combs, CA, Gravett, M, Garite, TJ, Hickok, DE, Lapidus, 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