Decreased cervical proinflammatory cytokines permit subsequent upper genital tract infection during pregnancy.
OBJECTIVE
The purpose of this study was to test the hypothesis that suppressed immune function in the lower genital tract, as represented by decreased concentrations of cervical proinflammatory cytokines early in pregnancy, is a risk factor for clinical chorioamnionitis.


METHODS
Interleukin-1beta, interleukin-6, and interleukin-8 were measured by enzyme-linked immunosorbent assay in cervical fluid from a cohort of 403 women at 8 to 20 weeks of gestation.


RESULTS
Of the 88 women with one low cytokine concentration, 8.0% of the women had clinical chorioamnionitis compared with 4.4% among the 228 women with no low cytokines (adjusted odds ratio, 2.0; 95% CI, 0.7-5.8). Clinical chorioamnionitis occurred in 15 of the 87 women (17.2%), with two or three depressed cytokine concentrations compared with women with no low cytokines (adjusted odds ratio, 5.1; 95% CI, 2.0-13.0).


CONCLUSIONS
Genital tract immune hyporesponsiveness, as represented by low cervical concentrations of multiple cytokines, permits subsequent clinical chorioamnionitis.
Simhan
Hyagriv N
HN
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Research Institute, Pittsburgh, PA 15213, USA. hsimhan@mail.magee.edu
Caritis
Steve N
SN
Krohn
Marijane A
MA
Martinez de Tejada
Begoña
B
Landers
Daniel V
DV
Hillier
Sharon L
SL
D000293:Adolescent; D000328:Adult; D044383:Black People; D002584:Cervix Uteri / Q000378:metabolism*; D002821:Chorioamnionitis / Q000209:etiology*; D016207:Cytokines / Q000378:metabolism*; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism*; D016015:Logistic Models; D016017:Odds Ratio; D009994:Osmolar Concentration; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000209:etiology*; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000378:metabolism; D044465:White People
D016207:Cytokines; D018836:Inflammation Mediators