Interleukin-18 in cervical mucus and amniotic fluid: relationship to microbial invasion of the amniotic fluid, intra-amniotic inflammation and preterm delivery.
OBJECTIVE
To evaluate the relationship between interleukin (IL)-18 in cervical mucus and amniotic fluid and microbial invasion of amniotic fluid, preterm delivery and intra-amniotic inflammation in women in preterm labour, with preterm prelabour rupture of membranes and at term.


METHODS
A prospective follow up study.


METHODS
Sahlgrenska University Hospital, Göteborg, Sweden.


METHODS
Women with singleton pregnancies (<34 weeks) presenting with preterm labour (n = 87) or preterm prelabour rupture of membranes (n = 47) and women, not in labour, at term (n = 28).


METHODS
Amniotic fluid was retrieved transabdominally. Cervical mucus was taken from the uterine cervix of women in preterm labour and at term. IL-18 was analysed with enzyme-linked immunosorbent assay.


METHODS
IL-18 in relation to microbial invasion of the amniotic fluid, delivery within seven days or <34 weeks of gestation and intra-amniotic inflammation.


RESULTS
The levels of IL-18 in cervical mucus and amniotic fluid were higher in women with preterm labour than in those not in labour at term. In the preterm labour group, significant associations were found between elevated IL-18 in amniotic fluid and microbial invasion of the amniotic fluid, as well as between delivery within seven days or <34 weeks of gestation and intra-amniotic inflammation. Delivery was delayed longer in the preterm prelabour rupture of membranes subgroup with IL-18 >or=1.0 ng/mL than in that with IL-18 <1.0 ng/mL.


CONCLUSIONS
In the preterm labour group, high IL-18 in amniotic fluid (but not in the cervix) was associated with microbial invasion of the amniotic fluid, intra-amniotic inflammation and prompt delivery. On the other hand, elevated IL-18 in preterm prelabour rupture of the membranes group correlated with a longer interval to delivery.
Jacobsson
Bo
B
Department of Obstetrics and Gynaecology, Institute for the Health of Women and Children, Sahlgrenska University Hospital/East, Göteborg, Sweden.
Holst
Rose-Marie
RM
Mattsby-Baltzer
Inger
I
Nikolaitchouk
Natalia
N
Wennerholm
Ulla-Britt
UB
Hagberg
Henrik
H
D000328:Adult; D000650:Amnion / Q000382:microbiology; D000653:Amniotic Fluid / Q000737:chemistry / Q000382:microbiology*; D002582:Cervix Mucus / Q000737:chemistry / Q000382:microbiology*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000382:microbiology; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007249:Inflammation / Q000382:microbiology; D020382:Interleukin-18 / Q000378:metabolism*; D007752:Obstetric Labor, Premature / Q000382:microbiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology*; D011446:Prospective Studies
D020382:Interleukin-18