4.2 Article

Intra-amniotic infection and sterile intra-amniotic inflammation are associated with elevated concentrations of cervical fluid interleukin-6 in women with spontaneous preterm labor with intact membranes

Journal

JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
Volume 35, Issue 25, Pages 4861-4869

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/14767058.2020.1869932

Keywords

Microbial invasion of the amniotic cavity; cytokine; intra-amniotic inflammation; noninvasive sample; preterm delivery

Funding

  1. PERSONMED -Center for the Development of Personalized Medicine in Age-Related Diseases [CZ.02.1.01/0.0/0.0/17_048/0007441]

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This study aimed to determine the concentration of IL-6 in cervical fluid in women with PTL. Results showed that women with intra-amniotic infection and sterile intra-amniotic inflammation had higher concentrations of IL-6 in cervical fluid compared to those without intra-amniotic inflammation, indicating an association between intra-amniotic inflammation and elevated IL-6 levels in cervical fluid.
Objective: To determine the concentration of interleukin-6 (IL-6) in the cervical fluid in women with spontaneous preterm labor with intact fetal membranes (PTL) complicated by intra-amniotic infection (the presence of both microbial invasion of the amniotic cavity and intra-amniotic inflammation), or sterile intra-amniotic inflammation (the presence of intra-amniotic inflammation alone). Methods: Eighty women with singleton pregnancies complicated by PTL between gestational ages 22 + 0 and 34 + 6 weeks were included in this retrospective cohort study. Samples of amniotic and cervical fluids were collected at the time of admission. Amniotic fluid samples were obtained via transabdominal amniocentesis, and cervical fluid was obtained using a Dacron polyester swab. Microbial invasion of the amniotic cavity was diagnosed based on the combination of culture and molecular biology methods. The concentration of IL-6 in the amniotic and cervical fluids were measured using an automated electrochemiluminescence immunoassay method. Intra-amniotic inflammation was defined as an amniotic fluid IL-6 concentration >= 3000 pg/mL. Results: The presence of intra-amniotic infection and sterile inflammation was identified in 15% (12/80) and 26% (21/80) of the women, respectively. Women with intra-amniotic infection (median: 587 pg/mL; p = .01) and with sterile intra-amniotic inflammation (median: 590 pg/mL; p = .005) had higher concentrations of IL-6 in the cervical fluid than those without intra-amniotic inflammation (intra-amniotic infection: median 587 pg/mL vs. without inflammation, median: 136 pg/mL; p = .01; sterile intra-amniotic inflammation, median: 590 pg/mL vs. without inflammation, p = .005). No differences were found in the concentrations of IL-6 in the cervical fluid between women with intra-amniotic infection and sterile intra-amniotic inflammation (p = .81). Conclusion: In pregnancies with PTL, both forms of intra-amniotic inflammation are associated with elevated concentrations of IL-6 in the cervical fluid.

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