Interpregnancy Interval and Anti-inflammatory Cervical Cytokines among Women with Previous Spontaneous Preterm Birth.

Abstract

Both history of spontaneous preterm birth (sPTB) and shorter interpregnancy intervals (IPIs) increase the risk of recurrent sPTB. Mechanisms underlying the association between IPI and recurrent sPTB are unknown. We have previously demonstrated that higher concentrations of cervical anti-inflammatory cytokines are a risk factor for sPTB and upper genital tract inflammation. Here, we examine the association between IPI and cervical anti-inflammatory cytokines among women with previous sPTB. A prospective cohort of 73 women with previous sPTB and cervical interleukins (IL-4, IL-10, and IL-13) measured at < 16 weeks. Using the published principal factor analysis, the anti-inflammatory (ANTI) score was calculated. From our previous work, higher ANTI scores increase the subsequent risk of sPTB. IPI was the time from the previous birth to the conception of current pregnancy. Confounders included education level, marital status, gonorrhea, chlamydia, body mass index, race, and cigarette smoking. IPI and ANTI score were analyzed using univariable and multivariable analyses. There was a significant negative linear relation between IPI and ANTI score (β = -0.075, p = 0.017). This persisted after adjustment for confounders (p = 0.02). As IPI decreases by 1 month, the ANTI-score-associated risk of sPTB increases approximately by 4%. Among women with previous sPTB, there was a significant negative linear relation between IPI and ANTI score.