Tissue concentrations of cytokines in the lower uterine segment during preterm parturition.
OBJECTIVE
To determine the concentrations of tumor necrosis factor alpha, interleukin-1 beta, interleukin-6, and interleukin-8 in the lower uterine segment during preterm parturition.


METHODS
In 71 patients who delivered prematurely by non-elective cesarean tissue specimens were obtained from the lower uterine segment. The patients were grouped in relation to the stage of cervical dilatation (< 2 cm, 2- < 4 cm, > or = 4 cm), duration of labor (< or = 6 h, > 6-12 h; > 12 h), and parity (1 versus > 1). Cytokine concentrations in protein extracts of the tissue samples were measured using enzyme-linked immunosorbent assays.


RESULTS
Median concentration of tumor necrosis factor alpha did not change, but that of interleukin-1 beta, interleukin-6, and interleukin-8 were significantly higher at 2- < 4 cm than at < 2 cm cervical dilatation (6.6, 67.7, and 125.8 versus 1.1, 17.6, and 22.2 pg/mg protein, respectively). The concentrations of interleukin-6 and interleukin-8 showed a further increase at > or = 4 cm (297.2 and 468.6 pg/mg, respectively), but for interleukin-1 beta a decrease was observed (0.6 pg/mg). Cytokine concentrations were not related to duration of labor or parity.


CONCLUSIONS
Local inflammation-associated changes that are mainly related to the stage of cervical dilatation and to only a minor degree to uterine activity may play a crucial role in preterm parturition.
Winkler
M
M
Department of Obstetrics and Gynaecology, University Hospital, Technical University, Aachen, Germany. mwinkler@post.klinikum.rwth-aachen.de
Kemp
B
B
Fischer
D C
DC
Maul
H
H
Hlubek
M
M
Rath
W
W
D000328:Adult; D001706:Biopsy; D001724:Birth Weight; D002585:Cesarean Section; D016207:Cytokines / Q000032:analysis*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007375:Interleukin-1 / Q000032:analysis; D015850:Interleukin-6 / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D007747:Labor Stage, First; D016014:Linear Models; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D014599:Uterus / Q000737:chemistry*
D016207:Cytokines; D007375:Interleukin-1; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha