Document Detail


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.
MedLine Citation:
PMID:  15901266     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Intrauterine infection and inflammation in women with preterm labor are related to adverse perinatal outcome. Due to its subclinical nature, a correct diagnosis depends on retrieval of amniotic fluid. Amniocentesis is, however, not performed as a clinical routine because of its invasiveness. Hypothetically, cytokines in the cervical fluid may represent an alternative diagnostic approach. The aim was to examine cervical interleukin (IL)-6 and IL-8 in relation to microbial invasion of the amniotic fluid, intra-amniotic inflammation, and preterm birth in women in preterm labor. METHODS: Women with singleton pregnancies in preterm labor (<34 weeks of gestation) and intact membranes were included. Cervical (n = 91) and amniotic fluids (n = 56) were collected. Polymerase chain reaction for Ureaplasma urealyticum and Mycoplasma hominis and culture for aerobic and anaerobic bacteria were performed. IL-6 and IL-8 were analyzed with enzyme-linked immunosorbent assay. RESULTS: Non-lactobacillus-dominated biota was detected in cervical secretion in 25% (22/89) and the presence of micro-organisms in the amniotic fluid in 16% (9/56) of the patients. The presence of U. urealyticum in the cervical fluid (21/46) was associated with significantly higher levels of IL-6 in the secretion. IL-6 and IL-8 were significantly higher in cervical fluid of women with intra-amniotic infection and inflammation and in women who delivered < or =7 days and/or before 34 weeks of gestation. Cervical IL-6 > or = 1.7 ng/ml was related to intra-amniotic inflammation (relative risk: 2.67; range: 1.50-4.74) and had a sensitivity, specificity, positive predictive value, and negative predictive value of 58, 83, 75, and 69%, respectively, in the identification of intra-amniotic inflammation. Similar data were obtained for IL-8 > or = 6.7 ng/ml. CONCLUSIONS: High levels of cervical IL-6 and IL-8 are moderately predictive of intrauterine infection/inflammation and preterm delivery.
Authors:
Rose-Marie Holst; Inger Mattsby-Baltzer; Ulla-Britt Wennerholm; Henrik Hagberg; Bo Jacobsson
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  84     ISSN:  0001-6349     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-05-19     Completed Date:  2005-06-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  551-7     Citation Subset:  IM    
Affiliation:
Perinatal Center, Department of Obstetrics and Gynecology, Institute for the Health of Women and Children, Sahlgrenska University Hospital, Göteborg, Sweden. rose-marie.holst@vgregion.se
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MeSH Terms
Descriptor/Qualifier:
Adult
Amniotic Fluid / metabolism,  microbiology
Biological Markers / metabolism
Cervix Uteri / metabolism*,  microbiology*
Cohort Studies
DNA, Bacterial / analysis
Enzyme-Linked Immunosorbent Assay
Female
Humans
Interleukin-6 / metabolism
Interleukin-8 / metabolism
Mycoplasma hominis / genetics,  isolation & purification
Obstetric Labor, Premature / diagnosis*,  metabolism,  microbiology
Polymerase Chain Reaction
Predictive Value of Tests
Pregnancy
Prenatal Diagnosis / methods
Prospective Studies
Sensitivity and Specificity
Sweden
Ureaplasma urealyticum / genetics,  isolation & purification
Chemical
Reg. No./Substance:
0/Biological Markers; 0/DNA, Bacterial; 0/Interleukin-6; 0/Interleukin-8

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