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

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.

[1]  K. Park,et al.  Prediction of imminent preterm delivery in women with preterm premature rupture of membranes , 2012, Journal of perinatal medicine.

[2]  B. Jacobsson,et al.  Prediction of microbial invasion of the amniotic cavity in women with preterm labour: analysis of multiple proteins in amniotic and cervical fluids , 2011, BJOG : an international journal of obstetrics and gynaecology.

[3]  E. Gratacós,et al.  Cervical length and gestational age at admission as predictors of intra‐amniotic inflammation in preterm labor with intact membranes , 2009, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[4]  E. Gratacós,et al.  Predictive value of combined amniotic fluid proteomic biomarkers and interleukin-6 in preterm labor with intact membranes. , 2009, American journal of obstetrics and gynecology.

[5]  B. Jacobsson,et al.  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. , 2005, Acta obstetricia et gynecologica Scandinavica.

[6]  B. Jacobsson,et al.  Interleukin‐6 and interleukin‐8 in cervical and amniotic fluid: relationship to microbial invasion of the chorioamniotic membranes , 2005, BJOG : an international journal of obstetrics and gynaecology.

[7]  Viswanath Devanarayan,et al.  Development, validation, and implementation of a multiplex immunoassay for the simultaneous determination of five cytokines in human serum. , 2005, Journal of pharmaceutical and biomedical analysis.

[8]  W. Kuis,et al.  Peripheral Blood Mononuclear Cells Cytokines in a Single Sample of Stimulated Simultaneous Detection of 15 Human , 2002 .

[9]  R. Romero,et al.  Clinical significance of intra-amniotic inflammation in patients with preterm labor and intact membranes. , 2001, American journal of obstetrics and gynecology.

[10]  M. Krohn,et al.  Vaginal Indicators of Amniotic Fluid Infection in Preterm Labor , 2001, Obstetrics and gynecology.

[11]  D. Arduini,et al.  Interleukin-6 concentrations in cervical secretions identify microbial invasion of the amniotic cavity in patients with preterm labor and intact membranes. , 1996, American journal of obstetrics and gynecology.

[12]  R. Romero,et al.  Amniotic fluid interleukin-6: a sensitive test for antenatal diagnosis of acute inflammatory lesions of preterm placenta and prediction of perinatal morbidity. , 1995, American journal of obstetrics and gynecology.

[13]  M. Sullivan,et al.  Transfer of cytokines through human fetal membranes , 1994, Journal of reproduction and fertility.

[14]  R. Gomez,et al.  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. , 1994, American journal of obstetrics and gynecology.

[15]  C. Lockwood Recent advances in elucidating the pathogenesis of preterm delivery, the detection of patients at risk, and preventative therapies , 1994, Current opinion in obstetrics & gynecology.

[16]  R. Romero,et al.  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. , 1993, American journal of obstetrics and gynecology.

[17]  M. Mazor,et al.  Infection and preterm labor. , 1988, Clinical obstetrics and gynecology.

[18]  E. DeLong,et al.  Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. , 1988, Biometrics.

[19]  D. Ingbar,et al.  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. , 1986, The American review of respiratory disease.