710 Mid-gestation cervicovaginal cytokines correlate with gestational age at delivery in women with prior preterm birth

Abstract

Our objective was to identify if the baseline cervico-vaginal cytokine profile differed in women with a history of preterm birth in comparison to women with only term births and to determine if there are cytokine predictors for preterm delivery. This was a sub-analysis of a multicenter prospective observational trial comparing the pregnancy outcomes in women without and with a history of preterm birth. Women with a cervical length <25mm were excluded from the study. Cervicovaginal fluid was collected from the posterior fornix for baseline assessment prior to any treatments. Maternal and pregnancy characteristics were collected. We performed unbiased multiplex luminex profiling on 37 cytokines and compared women with a history of preterm birth to controls as well as pregnancy characteristics. Pregnancy characteristics including age, BMI, race did not differ between groups. Women with a prior preterm birth delivered at an earlier gestational age than controls (39.4 w compared to 37.6 w) p=0.0012. We found that several cervicovaginal fluid cytokines were different in women with a prior preterm birth than controls. IL-26 (p=0.04), IL-6R-beta (p=0.03), MMP-2 (p=0.02) were elevated in women with a prior preterm birth (Figure 1). We found no correlations in baseline cervicovaginal cytokine levels and gestational age at delivery in the combined cohort. In women with prior preterm birth, both IL-26 and IL-27 correlated with gestational age at delivery (Figure 2) We found that several cervicovaginal fluid cytokines were elevated in the second trimester in women with a prior preterm birth, suggesting aberrations in inflammatory pathways are important in the pathogenesis of recurrent preterm birth. Additionally, our data suggest that the cervicovaginal immune profile may predict risk of preterm birth in high risk women and suggests that further investigation into the immune modulation of cervicovaginal fluid is warranted.View Large Image Figure ViewerDownload Hi-res image Download (PPT)