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Abstract

Objective: To determine the value of cervicovaginal interleukin (IL)-1β, IL-6, and IL-8 in predicting intra-amniotic infection and/or inflammation (IAI) in women with preterm labor. Methods: Cervicovaginal fluid samples were collected for IL-1β, IL-6, and IL-8 measurements immediately before amniocentesis in 85 consecutive women with preterm labor. The IAI was defined as a positive amniotic fluid (AF) culture and/or an elevated AF IL-6 level (>2.6 ng/mL). Results: Receiver–operating characteristic curves demonstrated that cervicovaginal IL-6 and IL-8, but not IL-1β, predicted IAI. Cervicovaginal IL-6 had a significantly higher area under the curve (AUC) than cervicovaginal IL-8 (P = .009). However, the AUCs for the cervicovaginal IL-6 and AF white blood cell (WBC) were not significantly different. Conclusions: Among measured cytokines, cervicovaginal IL-6 is the best marker to noninvasively identify IAI in women with preterm labor. Overall, this noninvasive parameter performed as well as AF WBC count for predicting IAI.

Keywords

cervicovaginal fluid intra-amniotic infection/inflammation interleukin 6 noninvasive preterm labor

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References

Yoon

Romero

Moon

Clinical significance of intra-amniotic inflammation in patients with preterm labor and intact membranes. Am J Obstet Gynecol. 2001;185(5):1130–1136.

Palacio

Cobo

Bosch

Cervical length and gestational age at admission as predictors of intra-amniotic inflammation in preterm labor with intact membranes. Ultrasound Obstet Gynecol. 2009;34(4):441–447.

Lockwood

. Recent advances in elucidating the pathogenesis of preterm delivery, the detection of patients at risk, and preventative therapies. Curr Opin Obstet Gynecol. 1994;6(1):7–18.

Sibille

Lwebuga-Mukasa

Polomski

Merrill

Ingbar

Gee

. An in vitro model for polymorphonuclear-leukocyte-induced injury to an extracellular matrix. Relative contribution of oxidants and elastase to fibronectin release from amnionic membranes. Am Rev Respir Dis. 1986;134(1):134–140.

Jacobsson

Mattsby-Baltzer

Hagberg

. Interleukin-6 and interleukin-8 in cervical and amniotic fluid: relationship to microbial invasion of the chorioamniotic membranes. BJOG. 2005;112(6):719–724.

Holst

Hagberg

Wennerholm

Skogstrand

Thorsen

Jacobsson

. Prediction of microbial invasion of the amniotic cavity in women with preterm labour: analysis of multiple proteins in amniotic and cervical fluids. BJOG. 2010;118(2):240–249.

Hitti

Hillier

Agnew

Krohn

Reisner

Eschenbach

. Vaginal indicators of amniotic fluid infection in preterm labor. Obstet Gynecol. 2001;97(2):211–219.

Rizzo

Capponi

Rinaldo

Tedeschi

Arduini

Romanini

. 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(4 pt 1):812–817.

Holst

Mattsby-Baltzer

Wennerholm

Hagberg

Jacobsson

. Interleukin-6 and interleukin-8 in cervical fluid in a population of Swedish women in preterm labor: relationship to microbial invasion of the amniotic fluid, intra-amniotic inflammation, and preterm delivery. Acta Obstet Gynecol Scand. 2005;84(6):551–557.

10.

Yoon

Romero

Kim

Amniotic fluid interleukin-6: a sensitive test for antenatal diagnosis of acute inflammatory lesions of preterm placenta and prediction of perinatal morbidity. Am J Obstet Gynecol. 1995;172(3):960–970.

11.

de Jager

te Velthuis

Prakken

Kuis

Rijkers

. Simultaneous detection of 15 human cytokines in a single sample of stimulated peripheral blood mononuclear cells. Clin Diagn Lab Immunol. 2003;10(1):133–139.

12.

DeLong

Clarke-Pearson

. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988;44(3):837–845.

13.

Romero

Mazor

. Infection and preterm labor. Clin Obstet Gynecol. 1988;31:553–584.

14.

Kent

Sullivan

Elder

. Transfer of cytokines through human fetal membranes. J Reprod Fertil. 1994;100(1):81–84.

15.

Romero

Yoon

Mazor

The diagnostic and prognostic value of amniotic fluid white blood cell count, glucose, interleukin-6, and gram stain in patients with preterm labor and intact membranes. Am J Obstet Gynecol. 1993;169(4):805–816.

16.

Cobo

Palacio

Navarro-Sastre

Predictive value of combined amniotic fluid proteomic biomarkers and interleukin-6 in preterm labor with intact membranes. Am J Obstet Gynecol. 2009;200(5):499 e491–496.

17.

Coultrip

Lien

Gomez

Kapernick

Khoury

Grossman

. The value of amniotic fluid interleukin-6 determination in patients with preterm labor and intact membranes in the detection of microbial invasion of the amniotic cavity. Am J Obstet Gynecol. 1994;171(4):901–911.

18.

Park

Lee

Kim

Jeong

Ryu

. Prediction of imminent preterm delivery in women with preterm premature rupture of membranes. J Perinat Med. 2012;40:151–157.

19.

Ray

Bowsher

Smith

Development, validation, and implementation of a multiplex immunoassay for the simultaneous determination of five cytokines in human serum. J Pharm Biomed Anal. 2005;36(5):1037–1044.

Noninvasive Prediction of Intra-amniotic Infection and/or Inflammation in Women With Preterm Labor

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