title: Interleukin-18 in cervical mucus and amniotic fluid: relationship to microbial invasion of the amniotic fluid, intra-amniotic inflammation and preterm delivery.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, Institute for the Health of Women and Children, Sahlgrenska University Hospital/East, Göteborg, Sweden.
authors.forename: Bo
authors.initials: B
authors.lastname: Jacobsson
authors.forename: Rose-Marie
authors.initials: RM
authors.lastname: Holst
authors.forename: Inger
authors.initials: I
authors.lastname: Mattsby-Baltzer
authors.forename: Natalia
authors.initials: N
authors.lastname: Nikolaitchouk
authors.forename: Ulla-Britt
authors.initials: UB
authors.lastname: Wennerholm
authors.forename: Henrik
authors.initials: H
authors.lastname: Hagberg
mesh_terms: 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
chemical_list: D020382:Interleukin-18