Document Detail


Is amniotic fluid analysis the key to preterm labor? A model using interleukin-6 for predicting rapid delivery.
MedLine Citation:
PMID:  9704784     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our purpose was to create a model for predicting amnionitis and rapid delivery in preterm labor patients by use of amniotic fluid interleukin-6 and clinical parameters. STUDY DESIGN: Amniotic fluid was cultured and analyzed, and a clinical score (incorporating gestational age, amniotic fluid Gram stain, glucose, leukocyte esterase, and maternal serum C-reactive protein) was determined in 111 patients diagnosed with preterm labor. Statistical analysis involved t tests, chi2, logarithmic regression, and multivariate regression analysis (P < or = .05). RESULTS: The incidence of positive amniotic fluid cultures was 8.7% (9 of 103 patients). Patients with positive cultures of the amniotic fluid had a shorter delivery interval (4.8 +/- 7.5 vs 28.9 +/- 25.4 days, P < .001). Patients with elevated amniotic fluid interleukin-6 (> or = 7586 pg/ml) were more likely to have a positive amniotic fluid culture (relative risk = 8.8, 95% confidence interval = 1.6 to 47.4, P < .001) and to be delivered within 2 days (relative risk = 16.8, 95% confidence interval = 4.5 to 62.7, P < .001). Stepwise multivariate regression analysis yielded a model using interleukin-6, cervical dilatation, and gestational age (r2 = 0.63, P < .001) with a specificity of 100% for predicting delivery within 2 days of amniocentesis. CONCLUSIONS: A mathematical model using maternal amniotic fluid interleukin-6 seems to be a useful clinical tool for quantifying the interval to preterm birth for patients in preterm labor.
Authors:
L S Greci; G J Gilson; B Nevils; L A Izquierdo; C R Qualls; L B Curet
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  179     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-09-03     Completed Date:  1998-09-03     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  172-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, USA.
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MeSH Terms
Descriptor/Qualifier:
Amniotic Fluid / chemistry,  microbiology*
Biological Markers / chemistry
Chorioamnionitis / diagnosis*
Delivery, Obstetric / methods*
Female
Gestational Age
Humans
Interleukin-6 / analysis*
Obstetric Labor, Premature / metabolism*
Predictive Value of Tests
Pregnancy
ROC Curve
Regression Analysis
Sensitivity and Specificity
Time Factors
Grant Support
ID/Acronym/Agency:
5T35HD074603/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Interleukin-6

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


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