Amniotic fluid inflammatory score is associated with pregnancy outcome in patients with mid trimester short cervix

Abstract

We propose a novel amniotic fluid inflammatory score from a comprehensive cytokine analysis of patients with mid-trimester short cervix. Amniotic fluid from singleton gestations (n = 44) with a cervical length of ≤25 mm between 16-24 weeks was assayed for 25 inflammatory mediators. Patient data were stratified according to gestational age at delivery (<34 vs ≥34 weeks). Mediators that reached statistical significance were included in the amniotic fluid inflammatory score. Patients were assigned 1 point for each significant mediator if their level was in the upper quartile. The amniotic fluid inflammatory score was determined, and its relationship to other clinical characteristics was examined. Fourteen mediators met the criteria. A score of ≥8 was predictive of delivery at <34 weeks' gestation (sensitivity, 87.0%; specificity, 100%; positive predictive value, 100%; negative predictive value, 87.5%). Twenty patients had a high inflammatory score (≥8); 24 patients had a low score. All patients with a high inflammatory score delivered at <30 weeks' gestation. The amniotic fluid inflammatory score is related to delivery outcome and clinical characteristics.