Document Detail


Increased interleukin-6 concentrations in cervical secretions are associated with preterm delivery.
MedLine Citation:
PMID:  7943078     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This study sought to determine whether elevated concentrations of interleukin-6 in the cervical and vaginal secretions of patients between 24 and 36 weeks' gestation predicted subsequent preterm delivery and/or identified those preterm deliveries associated with maternal infectious morbidity. STUDY DESIGN: A cohort study was undertaken with cervical and vaginal samples collected from 161 consenting patients seen at 3- to 4-week intervals between 24 and 36 weeks. Levels of interleukin-6 were measured by immunoassay. Demographic, obstetric, neonatal, and laboratory data were analyzed by Fisher's exact test, Student t test, or Wilcoxon rank sum test, linear and multiple logistic regression, and receiver-operator characteristic curve analysis. RESULTS: There were 4.2-fold and 3.4-fold increases in maximal cervical and vaginal interleukin-6 concentrations, respectively, among patients with preterm deliveries versus term deliveries. The receiver-operator characteristics curve analysis indicated that a single cervical interleukin-6 value > 250 pg/ml of sample buffer, present between 24 and 36 weeks' gestation, optimally identified patients with subsequent preterm deliveries versus term deliveries (sensitivity 50.0%, 95% confidence interval 33.2% to 66.8%; specificity 85.0%, 95% confidence interval 78.8% to 91.2%; positive predictive value 47.2%, 95% confidence interval 30.9% to 63.5%; negative predictive value 86.4%, 95% confidence interval 80.4% to 92.4%). The optimal vaginal interleukin-6 cutoff value (> 125 pg/ml) proved less sensitive (45.5%, 95% confidence interval 28.5% to 62.4%) but equally specific (86.6%, 95% confidence interval 80.7% to 92.5%). Multiple logistic regression indicated that a cervical interleukin-6 level > 250 pg/ml was an independent predictor of preterm delivery (adjusted odds ratio 4.8, 95% confidence interval 1.7 to 14.3). Cervical interleukin-6 levels did not correlate with cervical change or gestational age at sampling. Among patients delivered preterm there were no differences in the mean white blood cell count on admission or the prevalence of vaginal pathogens, alkaline vaginal pH, chorioamnionitis, or endometritis among patients with cervical interleukin-6 values > 150 or < or = 250 pg/ml. CONCLUSIONS: Cervical interleukin-6 is a relatively insensitive, although fairly specific discriminator of patients with subsequent preterm deliveries. Among patients delivered preterm, elevated cervical interleukin-6 values are not apparently associated with maternal infectious morbidity.
Authors:
C J Lockwood; A Ghidini; R Wein; R Lapinski; D Casal; R L Berkowitz
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  171     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1994 Oct 
Date Detail:
Created Date:  1994-11-15     Completed Date:  1994-11-15     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1097-102     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, NY 10029.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cervix Uteri / metabolism*
Chi-Square Distribution
Cohort Studies
Female
Humans
Interleukin-6 / metabolism*
Logistic Models
Obstetric Labor, Premature / metabolism*
Odds Ratio
Predictive Value of Tests
Pregnancy
Pregnancy Complications, Infectious / metabolism
ROC Curve
Risk Factors
Sensitivity and Specificity
Vagina / metabolism
Vaginal Smears
Chemical
Reg. No./Substance:
0/Interleukin-6

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


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