Open AccessInterleukin‐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
Author(s) -
Holst RoseMarie,
MattsbyBaltzer Inger,
Wennerholm UllaBritt,
Hagberg Henrik,
Jacobsson Bo
Publication year - 2005
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.0001-6349.2005.00708.x
Subject(s) - amniotic fluid , medicine , ureaplasma urealyticum , ureaplasma , obstetrics , anaerobic bacteria , amniocentesis , chorioamnionitis , gestation , cervical cerclage , mycoplasmataceae , inflammation , mycoplasma hominis , population , pregnancy , gynecology , mycoplasma , immunology , mollicutes , fetus , biology , microbiology and biotechnology , prenatal diagnosis , bacteria , genetics , environmental health
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 ≤7 days and/or before 34 weeks of gestation. Cervical IL‐6 ≥ 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 ≥ 6.7 ng/ml. Conclusions. High levels of cervical IL‐6 and IL‐8 are moderately predictive of intrauterine infection/inflammation and preterm delivery.