Expression Of NF-?B In Premature Rupture Of Membranes With Intrauterine Infection And Its Predictive Value

ObjectiveIn this paper,the expression levels of NF-?B in peripheral blood,cord blood,amniotic fluid and placenta of patients with premature rupture of membranes(PPROM)were measured to explore the role and diagnostic value of NF-?B in the pathogenesis of premature rupture of membranes(PPROM)with intrauterine infection,to provide basis for early clinical discovery and diagnosis and treatment.MethodsFrom September 2017 to December 2018,pregnant women with preterm premature rupture of membranes who met the inclusion criteria were selected for obstetric delivery in Yangzhou University School of clinical medicine.According to the results of fetal membrane histopathology,they were divided into control group(preterm premature rupture of membranes without intrauterine infection group)and case group(preterm premature rupture of membranes with intrauterine infection group).Enzyme linked immunosorbent assay(ELISA)was used to detect NF-?B in maternal blood,cord blood and amniotic fluid.Western blot(WB)was used to detect the relative gray value of NF-?B in placenta.To compare the diagnostic value of NF-?B,white blood cell(WBC)and C-reactive protein(CRP).According to the existing clinical data of the patients,single factor analysis was carried out,and the risk factors with statistical differences were analyzed by logistic regression analysis.Independent risk factors were used to establish a prediction model and test its predictive value for premature rupture of membranes with intrauterine infection.The influence of NF-?B on the adverse outcome of neonates was analyzed.Results1.Basic data:42 cases in the control group and 49 cases in the case group.The incidence of intrauterine infection was 46.2%.The time from rupture of membrane to delivery in the case group was longer than that in the control group,and the expression of WBC and CRP was higher than that in the control group,with statistical differences(P<0.05);there were no statistical differences in age,pregnancy,delivery,gestational weeks,body temperature,body mass index(BMI)and delivery mode between the two groups(P>0.05).There was no significant difference between the case group and the control group in terms of neonatal weight,Apgar score and gender(P>0.05).2.Experimental results:the results of ELISA showed that the expression of NF-?B in maternal blood,cord blood and amniotic fluid of the case group was higher than that of the control group,and there were statistical differences(t=5.857,P<0.05;t=4.574,P<0.05;t=5.226,P<0.05).WB results showed that the relative gray value of NF-?B in placenta of patients in the case group was higher than that in the control group,and there was statistical difference between the two groups(t=6.616,P<0.05).There was a positive correlation between the expression of NF-?B in maternal blood and cord blood,maternal blood and placenta,and cord blood and placenta(r=0.839,P<0.05;r=0.844,P<0.05;r=0.774,P<0.05).3.The value of NF-?B in the diagnosis of premature rupture of membranes with intrauterine infection:the sensitivity and specificity of NF-?B in the diagnosis of premature rupture of membranes with intrauterine infection were 71.4%and 83.7%,respectively,and the area under the curve(AUC)was 0.812,the difference was statistically significant(P<0.05).4.Logistic prediction model of premature rupture of membranes with intrauterine infection:the regression equation was established by using independent risk factors.The logistic model was significant in general(?2=44.94,P<0.05)and had a high goodness of fit(P=0.063>0.05).For the prediction probability,receiver operating characteristic curve(ROC)was established,and AUC was 0.885(P<0.05).The accuracy of the model is 81.3%.5.Comparison of pregnancy outcome:the incidence of adverse outcome in the case group and the newborn was higher than that in the control group.The expression of NF-?B in maternal blood,cord blood and placenta was significantly different between the groups with and without neonatal lung disease(P<0.05).ConclusionsThe expression level of NF-?B in peripheral blood,cord blood,amniotic fluid and placenta of patients in the case group was higher than that in the control group.NF-?B may be involved in the occurrence and development of premature rupture of membranes with intrauterine infection.NF-?B has high sensitivity and specificity,which may be an effective index for the diagnosis of premature rupture of membranes with intrauterine infection.The established model can predict premature rupture of fetal membrane with intrauterine infection,which may have a certain clinical value.NF-?B may be related to the occurrence of lung diseases in neonates.