Decreased Proinflammatory Cytokines in Cervicovaginal Fluid, as Measured in Midgestation, are Associated with Preterm Delivery

Abstract

The main aim of this study was to investigate the relationship between selected proinflammatory cytokines [interleukin IL-1 alpha (IL-1alpha), IL-1 beta (IL-1beta), IL-6 and IL-8] concentrations in cervicovaginal fluid, as measured in midgestation, and the risk of subsequent preterm delivery. Cervicovaginal fluids were obtained from a cohort of 114 pregnant women at 22-34 weeks' gestation and analyzed for the concentrations of IL-1alpha, IL-1beta, IL-6 and IL-8 using enzyme-linked immunosorbent assay technique. Lower genital tract microbiology was diagnosed using Gram stain method and by culture. Mean gestational age at the time of sampling was 29.0 weeks. Mean time between sampling and delivery was 9.3 weeks (S.D. 4.7). Median cervicovaginal concentrations of IL-1alpha, IL-1beta, IL-6 and IL-8 did not differ between preterm and term delivery group. Women with lower genital tract pathological flora and IL-1alpha concentration below 25th percentile presented significant risk of subsequent preterm delivery as compared with women with no low cytokines (OR = 10.7; 95% CI, 2.0-58.1). Women with more than one cytokine' low concentration (below 25th percentile) presented an increased risk of preterm delivery--OR = 11.8 (95% CI, 1.8-78.0). The midgestation cytokines' measurement in cervicovaginal fluid of pregnant women could be useful for prediction of preterm delivery only among women with lower genital tract pathological flora.