Abstract
Objective: To compare the cervicovaginal cytokines IL-1β, IL-6 and IL-8 with fetal fibronectin
(fFN) and cervical dilatation in the prediction of preterm delivery. Study design: Cervicovaginal cytokine concentration and fFN status were measured in 104 women with
symptoms of preterm labour and intact membranes between 240 and 336 weeks and related to delivery within 2 and 7 days. Results: A group of 18% had cervical dilatation≥1 cm and 18% were positive for fFN. Preterm delivery within 2 and 7 days occurred in
5 and 12%, respectively. Only IL-6 demonstrated any ability to predict delivery within
2 and 7 days (area under the ROC curve=0.63 and 0.75, respectively). Using 35 pg/ml (75th centile) as a cut-off, IL-6 had a sensitivity and specificity of 60 and
77% for predicting delivery within 2 days, and 62 and 80% for predicting delivery
within 7 days. This is similar to the performance of cervical dilatation or fFN status.
Conclusions: Measurement of cervicovaginal cytokines has limited ability to predict imminent delivery
apart from cervicovaginal IL-6 concentrations, which, in this population, is equivalent
to that of fFN status and cervical dilatation≥1 cm.
Keywords
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References
Opsjln SL, Wathen NC, Tingulstad S, et al. Tumor necrosis factor, interleukin-1 and interleukin-6 in normal human pregnancy. Am J Obstet Gynecol 1993;169:397–404.
- Immunoendocrinology of preterm labour and delivery.Baillieres Clin. Obstet. Gynaecol. 1993; 7: 553-575
- Elevated placental cytokine release a process associated with preterm labor in the absence of intrauterine infection.Obstet. Gynecol. 1996; 88: 534-539
- Cytokine levels in amniotic fluid and inflammatory changes in the placenta from normal deliveries at term.Eur. J. Obstet. Gynecol. Reprod. Biol. 1994; 56: 153-160
- Characterization of the inflammatory cytokines in the vagina during pregnancy and labor and with bacterial vaginosis.J. Soc. Gynecol. Invest. 1997; 4: 90-94
Romero R, Sirtori M, Oyarzun E, et al. Infection and labor V. Prevalence microbiology and clinical significance of intraamniotic infection in women with preterm labor and intact membranes. Am J Obstet Gynecol 1989;161:817–24.
Romero R, Mazor M, Brandt F, et al. Interleukin-1 alpha and interleukin-1 beta in preterm and term human parturition. Am J Reprod Immunol 1992;27:117–23.
- Is amniotic fluid analysis the key to preterm labor? A model using interleukin-6 for predicting rapid delivery.Am. J. Obstet. Gynecol. 1998; 179: 172-178
- Amniotic fluid interleukin-6: correlation with upper genital tract microbial colonization and gestational age in women delivered after spontaneous labor versus indicated delivery.Am. J. Obstet. Gynecol. 1995; 173: 606-612
- The relationship of amniotic fluid cytokines and preterm delivery amniotic fluid infection histologic chorioamnionitis and chorioamnion infection.Obstet. Gynecol. 1993; 81: 941-948
- Interleukin 8 concentrations in amniotic fluid and peripheral venous plasma during human pregnancy and parturition.Acta Endocrinologica. 1993; 129: 220-224
- Amniotic fluid interleukin-10 concentrations increase through pregnancy and are elevated in patients with preterm labor associated with intrauterine infection.Am. J. Obstet. Gynecol. 1995; 173: 1223-1227
- Tumor necrosis factor in preterm and term labor.Am. J. Obstet. Gynecol. 1992; 166: 1576-1587
Romero R, Gomez R, Ghezzi F, et al. A fetal systemic inflammatory response is followed by the spontaneous onset of preterm parturition. Am J Obstet Gynecol 1998;179:186–93.
- Interleukin-6 concentrations in cervical secretions identify microbial invasion of the amniotic cavity in patients with preterm labor and intact membranes.Am. J. Obstet. Gynecol. 1996; 175: 812-817
- Increased interleukin-6 concentrations in cervical secretions are associated with preterm delivery.Am. J. Obstet. Gynecol. 1994; 171: 1097-1102
- The diagnostic value of interleukin-8 and fetal fibronectin concentrations in cervical secretions in patients with preterm labor and intact membranes.J. Perinat. Med. 1997; 25: 461-468
Inglis SR, Jeremias J, Kuno K, et al. Detection of tumor necrosis factor-alpha interleukin-6 and fetal fibronectin in the lower genital tract during pregnancy: relation to outcome. Am J Obstet Gynecol 1994;171:5–10.
- Distinct expression levels of cytokines and soluble cytokine receptors in seminal plasma of fertile and infertile men.Fertil. Steril. 1996; 66: 135-139
Coleman MAG, McCowan LME, Pattison NS, Mitchell MD. Fetal fibronectin detection in preterm labour; evaluation of a prototype bedside dipstick technique and cervical assessment. Am J Obstet Gynecol 1998;179(6 Pt 1):1553–8.
- Cytokine abundance in placental tissues; evidence of inflammatory activation in gestational membranes with term and preterm parturition.Am. J. Obstet. Gynecol. 1999; 181: 1530-1536
- The interleukin-1 system in gestational tissues at term: effect of labour.Placenta. 1997; 18: 717-723
- Interleukin-8 is a mediator of the final cervical ripening in humans.Eur. J. Obstet. Gynecol. Reprod. Biol. 1997; 74: 89-92
- Digital examination and transperineal ultrasonographic measurement of cervical length to assess risk of preterm delivery.Int. J. Gynaecol. Obstet. 1997; 59: 223-229
Article info
Publication history
Accepted:
June 12,
2000
Received in revised form:
May 11,
2000
Received:
September 23,
1999
Identification
Copyright
© 2001 Elsevier Science Ireland Ltd. Published by Elsevier Inc. All rights reserved.
