Predicting preterm delivery: comparison of cervicovaginal interleukin (IL)-1beta, IL-6 and IL-8 with fetal fibronectin and cervical dilatation.
OBJECTIVE
To compare the cervicovaginal cytokines IL-1beta, IL-6 and IL-8 with fetal fibronectin (fFN) and cervical dilatation in the prediction of preterm delivery.


METHODS
Cervicovaginal cytokine concentration and fFN status were measured in 104 women with symptoms of preterm labour and intact membranes between 24(0) and 33(6) weeks and related to delivery within 2 and 7 days.


RESULTS
A group of 18% had cervical dilatation > or = 1cm and 18% were positive for fFN. Preterm delivery within 2 and 7 days occurred in 5 and 12%, respectively. Only IL-6 demonstrated any ability to predict delivery within 2 and 7 days (area under the ROC curve = 0.63 and 0.75, respectively). Using 35pg/ml (75th centile) as a cut-off, IL-6 had a sensitivity and specificity of 60 and 77% for predicting delivery within 2 days, and 62 and 80% for predicting delivery within 7 days. This is similar to the performance of cervical dilatation or fFN status.


CONCLUSIONS
Measurement of cervicovaginal cytokines has limited ability to predict imminent delivery apart from cervicovaginal IL-6 concentrations, which, in this population, is equivalent to that of fFN status and cervical dilatation > or = 1cm.
Coleman
M A
MA
Department of Obstetrics and Gynaecology, University of Auckland School of Medicine, Private Bag 92019, Auckland, New Zealand.
Keelan
J A
JA
McCowan
L M
LM
Townend
K M
KM
Mitchell
M D
MD
D000328:Adult; D002584:Cervix Uteri / Q000378:metabolism* / Q000503:physiopathology*; D005260:Female; D005353:Fibronectins; D005865:Gestational Age; D006023:Glycoproteins / Q000032:analysis*; D006801:Humans; D007375:Interleukin-1 / Q000032:analysis; D015850:Interleukin-6 / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D007378:Interleukins / Q000032:analysis*; D016015:Logistic Models; D007752:Obstetric Labor, Premature / Q000175:diagnosis*; D011247:Pregnancy; D011446:Prospective Studies; D012372:ROC Curve; D014621:Vagina / Q000378:metabolism*
C403421:FFN protein, human; D005353:Fibronectins; D006023:Glycoproteins; D007375:Interleukin-1; D015850:Interleukin-6; D016209:Interleukin-8; D007378:Interleukins