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Vaginal matrix metalloproteinase-9 (MMP-9) as a potential early predictor of preterm birth

  • Jay A. Davis , David Baker , Tatyana Peresleni , Cassandra Heiselman ORCID logo , Christina Kocis , Michael Demishev and David J. Garry ORCID logo EMAIL logo
Published/Copyright: May 27, 2024
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 52 Issue 6

Abstract

Objectives

To evaluate the differences in vaginal matrix metalloproteinases (MMP) and tissue inhibitors of metalloproteinases (TIMPs) in pregnant patients with a history of prior preterm birth compared with controls.

Methods

A prospective cohort pilot study recruited patients during prenatal care with history of prior spontaneous preterm birth (high-risk group) or no history of preterm birth (low-risk/controls). Inclusion criteria were singleton gestation at 11–16 weeks and between 18 and 55 years of age. Exclusion criteria were diabetes mellitus, hypertension, diseases affecting the immune response or acute vaginitis. A vaginal wash was performed at time of enrollment, and patients were followed through delivery. Samples were analyzed using semi-quantitative analysis of MMPS and TIMPS. The study was approved by the IRB and a p-value <0.05 was considered significant.

Results

A total of 48 pregnant patients were recruited: 16 with a history of preterm birth (high-risk group) and 32 with no history of preterm birth (low-risk group/controls). Groups were similar in age, race, BMI, and delivery mode. The high-risk group had more multiparous women (100 vs. 68.8 %; p=0.02), a greater preterm birth rate (31.2 vs. 6.3 %; p=0.02), and a lower birth weight (2,885 ± 898 g vs. 3,480 ± 473 g; p=0.02). Levels of vaginal MMP-9 were greater in high-risk patients than low-risk patients (74.9 % ± 27.0 vs. 49.4 % ± 31.1; p=0.01). When dividing the cohort into patients that had a spontaneous preterm birth (7/48, 14.6 %) vs. those with a term delivery (41/48, 85.4 %), the vaginal MMP-9 remained elevated in the cohort that experienced a preterm birth (85.46 %+19.79 vs. 53.20 %+31.47; p=0.01). There were no differences in the other MMPS and in TIMPs between high and low-risk groups.

Conclusions

There was an increase in vaginal MMP-9 during early pregnancy in those at high risk for preterm birth and in those who delivered preterm, regardless of prior pregnancy outcome. Vaginal MMP-9 may have potential as a marker of increased risk of preterm birth.

Keywords: pregnancy; preterm birth prediction; inflammation; metalloproteinase
Corresponding author: David J. Garry, DO FACOG, Department of Obstetrics & Gynecology and Reproductive Medicine, Renaissance School of Medicine at Stony Brook University, 101 Nicolls Road HSC T-9 Room 03, Stony Brook, NY 11794, USA, E-mail:

  1. Research ethics: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013) and has been approved by our Institutional Review Board (IRB) approval (CORHIS #2016-3441-F).

  2. Informed consent: IRB approved and informed consent obtained on all patients.

  3. Author contributions: Jay A Davis: Data curation, Investigation, Methodology, Writing – original draft, Writing – review & editing. David Baker: Conceptualization, Formal analysis, Investigation, Supervision, Writing – original draft. Tatyana Peresleni: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Validation, Visualization, Writing – original draft, Cassandra Heiselman: Data curation, Formal analysis, Investigation, Supervision, Writing – original draft, Writing – review & editing. Chistine Kocis: Investigation, Writing – original draft. Michael Demishev: Investigation, Methodology, Writing – original draft. David J. Garry: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing.

  4. Competing interests: The authors state no conflict of interest.

  5. Research funding: None declared.

  6. Data availability: The raw data can be obtained on request from the corresponding author.

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Received: 2023-10-08
Accepted: 2024-05-13
Published Online: 2024-05-27
Published in Print: 2024-07-26

© 2024 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. Newborns at risk of COVID-19, the story continues
  4. Opinion Paper
  5. Why do women choose home births
  6. Original Articles – Obstetrics
  7. Association between aneuploidy screening analytes and adverse outcomes in twin gestations
  8. Vaginal matrix metalloproteinase-9 (MMP-9) as a potential early predictor of preterm birth
  9. Intrapartum pyrexia, cardiotocography traces and histologic chorioamnionitis: a case-control study
  10. Effect of maternal asthma on fetal pulmonary artery Doppler parameters: a case-control study
  11. Association of BDNF polymorphism with gestational diabetes mellitus risk: a novel insight into genetic predisposition
  12. Transvaginal three-dimensional ultrasound assessment of embryonic genital tubercle at 8–10+6 weeks of gestation
  13. Ultrasound prediction of fetal macrosomia in pregnancies complicated by diabetes mellitus: a systematic review and meta-analysis
  14. Comparative analysis of ultrasonographic fetal lung texture in twin and singleton fetuses
  15. Association between first-trimester uterine artery Doppler and crown-rump length with growth discordance: does it make a difference
  16. Original Articles – Fetus
  17. Evaluating fetal tricuspid and mitral annular plane systolic excursion (TAPSE and MAPSE) using spatiotemporal image correlation (STIC) M-mode
  18. Hepatic arterial buffer response in monochorionic twins with selective fetal growth restriction
  19. Original Articles – Neonates
  20. Increases in drug-related infant mortality in the United States
  21. Factors of poor prognosis in newborns with a prenatal diagnosis of gastroschisis in Bogota, Colombia
https://doi.org/10.1515/jpm-2023-0429
Keywords for this article
pregnancy; preterm birth prediction; inflammation; metalloproteinase

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. Newborns at risk of COVID-19, the story continues
  4. Opinion Paper
  5. Why do women choose home births
  6. Original Articles – Obstetrics
  7. Association between aneuploidy screening analytes and adverse outcomes in twin gestations
  8. Vaginal matrix metalloproteinase-9 (MMP-9) as a potential early predictor of preterm birth
  9. Intrapartum pyrexia, cardiotocography traces and histologic chorioamnionitis: a case-control study
  10. Effect of maternal asthma on fetal pulmonary artery Doppler parameters: a case-control study
  11. Association of BDNF polymorphism with gestational diabetes mellitus risk: a novel insight into genetic predisposition
  12. Transvaginal three-dimensional ultrasound assessment of embryonic genital tubercle at 8–10+6 weeks of gestation
  13. Ultrasound prediction of fetal macrosomia in pregnancies complicated by diabetes mellitus: a systematic review and meta-analysis
  14. Comparative analysis of ultrasonographic fetal lung texture in twin and singleton fetuses
  15. Association between first-trimester uterine artery Doppler and crown-rump length with growth discordance: does it make a difference
  16. Original Articles – Fetus
  17. Evaluating fetal tricuspid and mitral annular plane systolic excursion (TAPSE and MAPSE) using spatiotemporal image correlation (STIC) M-mode
  18. Hepatic arterial buffer response in monochorionic twins with selective fetal growth restriction
  19. Original Articles – Neonates
  20. Increases in drug-related infant mortality in the United States
  21. Factors of poor prognosis in newborns with a prenatal diagnosis of gastroschisis in Bogota, Colombia
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