Ethnic disparity in amniotic fluid levels of hyaluronan, histone H2B and superoxide dismutase in spontaneous preterm birth

Aims: To document racial disparity in an immune modulator, hyaluronan (HA), an antimicrobial, histone H2B (H2B), and an antioxidant, superoxide dismutase (SOD) in amniotic fluid (AF) from African-American (AA) and Caucasian (C) subjects with spontaneous preterm birth (PTB). Methods: In a case (PTB) control (term) study, AF samples were analyzed for HA, H2B and SOD by ELISA. Differences in analyte concentrations between races were documented and a secondary analysis based on histologic chorioamnionitis (HC) was also performed. Results: No differences in the median HA, H2B and SOD were seen between cases and controls. AA cases had lower HA but higher H2B and SOD than controls. Analyte concentrations were not different between C cases and controls. AA samples at term had lower H2B and SOD compared to C samples at term. Cases with HC showed higher H2B and SOD. Conclusion: We report ethnic disparity in AF anti microbial, immune mediator and antioxidant factors. Dysregulated AF production of HA, H2B and SOD was associated with PTB in AA, not in C, suggesting an overwhelming inflammatory response in AA PTB, whereas inflammation is likely a secondary phenomenon in C PTB.