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Prediction of impending preterm delivery based on sonographic cervical length and different cytokine levels in cervicovaginal fluid in preterm labor
Author(s) -
Jung Eun Young,
Park Jeong Woo,
Ryu Aeli,
Lee Sung Youn,
Cho Soohyun,
Park Kyo Hoon
Publication year - 2016
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12882
Subject(s) - medicine , cervix , preterm delivery , preterm labor , obstetrics , gynecology , receiver operating characteristic , logistic regression , gestation , gestational age , pregnancy , cancer , biology , genetics
Abstract Aims The aim of this study was to determine whether cervicovaginal interleukin (IL)‐1β, IL‐6 and IL‐8 levels, and cervical length, alone or in combination, could predict impending preterm delivery in women with preterm labor and intact membranes. Material and Methods Cervicovaginal swab samples for IL‐1β, IL‐6, and IL‐8 assays were taken from 136 consecutive women with preterm labor (23–34 weeks) before the transvaginal ultrasonography examination to measure cervical length. The primary outcome measurement was spontaneous preterm delivery within 7 days of sampling. Results Spontaneous preterm delivery within 7 days occurred in 28.6% (39/136) of patients. Receiver–operator characteristic (ROC) curves indicated that cervical length ( P < 0.001), cervicovaginal IL‐6 ( P < 0.001) and IL‐8 ( P = 0.014), but not IL‐1β, could predict delivery within 7 days. According to the logistic regression analysis, high cervicovaginal IL‐8 ( P = 0.008) and IL‐6 ( P = 0.038) levels and short cervical length ( P < 0.001) were significantly associated with delivery within 7 days, even after controlling for baseline variables. A combination of cervix length and cervicovaginal IL‐8 increased the specificity of detecting delivery within 7 days to 92.8%, which was superior to either test alone ( P < 0.001), but the sensitivity was only 56.4%. Conclusion In women with preterm labor, among the parameters assessed, cervicovaginal IL‐6 and IL‐8 and cervical length are the most important parameters in predicting impending preterm delivery. A combination of cervix length and cervicovaginal IL‐8 appeared to be the best for predicting impending preterm delivery, but the relatively low sensitivity of this test may limit its clinical usefulness.