Interleukin-8 mRNA in vaginal secretions: a prenatal marker of congenital infection in case of preterm labor with intact membranes.
OBJECTIVE
To study whether interleukin-8 (IL-8) mRNA in vaginal secretions is associated with congenital infection and preterm delivery in the case of preterm labor with intact membranes.


METHODS
This prospective clinical study in a tertiary referral center included 280 patients who gave birth to 360 infants from 1997 through 1999. IL-8 mRNA in vaginal secretions was determined with reverse transcriptase polymerase chain reaction. Logistic regression was used to examine the association between vaginal IL-8 mRNA and congenital infection independently of the time of birth. Main outcome measures were congenital infection and delivery before 37 and 33 weeks' gestation.


RESULTS
A total of 100 women (100/280 (35.7%)) gave birth before 37 weeks. A total of 54 children (54/360 (15%)) had congenital infection. IL-8 mRNA in vaginal secretions was associated with delivery within 14 days of the sampling (24 (15.6%) vs. 7 (5.6%) p < 0.01), but not with delivery within 48 h, 7 days (p = 0.07) or before 37 or 33 weeks. There were more congenital infections in the group with detectable IL-8 mRNA (37 (19.3%) than in the negative group (17 (10.1%); p < 0.05). IL-8 mRNA was associated with congenital infection independently of the time of birth (OR: 2.6 (1.3-5.1)). This test had a sensitivity for predicting neonatal infection of 69%. Its specificity was 49%, its positive predictive value 19%, and its negative predictive value 90%.


CONCLUSIONS
IL-8 mRNA could be a prenatal noninvasive vaginal marker of congenital infection.
Kayem
G
G
Department of Obstetrics and Gynaecology, Maternity Port-Royal, Cochin-Saint Vincent-de-Paul Hospital APHP, René Descartes University (Paris V), Paris, France. gilles.kayem@chicreteil.fr
Maillard
F
F
Batteux
F
F
Weill
B
B
Cabrol
D
D
Goffinet
F
F
D000328:Adult; D015415:Biomarkers; D002584:Cervix Uteri / Q000378:metabolism*; D017931:DNA Primers; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D016209:Interleukin-8 / Q000235:genetics*; D007752:Obstetric Labor, Premature; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011296:Prenatal Diagnosis; D011446:Prospective Studies; D012333:RNA, Messenger / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity
D015415:Biomarkers; D017931:DNA Primers; D016209:Interleukin-8; D012333:RNA, Messenger