Document Detail


Amniotic fluid interleukin-6 determinations are of diagnostic and prognostic value in preterm labor.
MedLine Citation:
PMID:  8311926     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PROBLEM: The purpose of this study was to determine if amniotic fluid concentrations of the interleukin-6 (IL-6) are of value in diagnosis of microbial invasion of the amniotic cavity and in the prediction of failure of tocolysis, preterm delivery and perinatal morbidity and mortality. METHOD: Amniotic fluid was obtained by transabdominal amniocentesis from 146 consecutive patients admitted with the diagnosis of preterm labor and intact membranes. Fluid was cultured for aerobic and anaerobic bacteria as well as for mycoplasmas. Amniotic fluid IL-6 levels were measured using a monoclonal antibody-based enzyme-linked immunosorbent assay with a sensitivity of 0.03 ng/ml. Logistic regression and Cox's proportional hazards model were used to examine the effect of several variables on dichotomous outcomes or interval to delivery. RESULTS: Patients with a positive amniotic fluid culture had a significantly higher amniotic fluid IL-6 concentrations than patients with a negative culture (median 91.2 ng/ml, range 0.9 to 437 ng/ml versus median 0.4 ng/ml, range < 0.3 to 195 ng/ml, respectively; P < .0001). An amniotic fluid IL-6 concentration of greater than or equal to 11.3 ng/ml had a sensitivity of 93.3% (14 of 15) and a specificity of 91.6% (120 of 131). All patients with an amniotic fluid IL-6 concentration above 11.3 ng/ml and a negative amniotic fluid culture (N = 11) delivered preterm and all placenta available for examination (N = 7) had histologic evidence of chorioamnionitis. Amniotic fluid concentrations of IL-6 were an independent predictor of preterm delivery, amniocentesis-to-delivery interval and neonatal morbidity and mortality. Moreover, IL-6 concentrations added significant information to the prediction of these outcomes to that provided only by clinical information such as cervical dilatation, gestational age at admission or at delivery. CONCLUSION: IL-6 is a sensitive and rapid test for the detection of microbial invasion of the amniotic cavity and for identifying women at risk for spontaneous preterm delivery and neonates at risk for morbidity and mortality.
Authors:
R Romero; B H Yoon; J S Kenney; R Gomez; A C Allison; P B Sehgal
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of reproductive immunology (New York, N.Y. : 1989)     Volume:  30     ISSN:  1046-7408     ISO Abbreviation:  Am. J. Reprod. Immunol.     Publication Date:    1993 Sep-Oct
Date Detail:
Created Date:  1994-03-24     Completed Date:  1994-03-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8912860     Medline TA:  Am J Reprod Immunol     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  167-83     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Hutzel Hospital, Detroit 48201.
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MeSH Terms
Descriptor/Qualifier:
Adult
Amniotic Fluid / immunology*
Chi-Square Distribution
Chorioamnionitis / diagnosis,  immunology
Female
Humans
Interleukin-6 / analysis*
Obstetric Labor, Premature / immunology,  prevention & control*
Pregnancy
Pregnancy Complications, Infectious / diagnosis,  immunology*
Prognosis
Regression Analysis
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Interleukin-6

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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