Detection of interleukin 6 mRNA by RT-PCR in vaginal secretions: association with preterm delivery and neonatal infection in women with preterm labour and intact membranes.
OBJECTIVE
To find a biological marker associated with preterm delivery or neonatal infection in pregnant women with preterm labour and intact membranes.


METHODS
Cervical secretions were collected from 286 women hospitalized for preterm labour with intact membranes at 24-34 weeks' gestation. The outcomes studied were delivery before 33 and 35 weeks' gestation, chorioamnionitis, and neonatal infection, and their association with the presence of IL-6 mRNA in cervical secretions as detected by RT-PCR. The other infectious markers tested were: bacterial vaginosis and fetal fibronectin in cervical secretions; serum CRP and white blood cell count.


RESULTS
The vaginal secretions of 13 of 286 women (4.7%) contained IL-6 mRNA. The only other marker tested significantly associated with IL-6 mRNA+ was the presence of streptococcus in vaginal secretions (30.8% versus 9.4% in the IL-6+ and-groups, p = 0.03). Although the difference did not reach statistical significance (p<0.06 and 0.08, respectively), in women with IL-6 mRNA in cervical secretions we observed a tendency to give birth before 33 and 35 weeks more often than the population as a whole. This group was at higher risk of neonatal infection (38.5% versus 15.1%; p = 0.04). After adjustment for infectious risk factors, IL-6 remained significantly associated with neonatal infection (OR = 4.6, 95% CI [1.1-18.9]). The sensitivity of IL-6 mRNA for neonatal infection was 11.1%. The specificity was 96.7%.


CONCLUSIONS
The detection of IL-6 mRNA by RT-PCR in vaginal secretions allows identification of a small group of women at high risk of neonatal infection, independently of other markers of infection.
Goffinet
François
F
Department of Obstetrics and Gynecology, Maternity Port-Royal, Cochin-Saint Vincent-de-Paul Hospital, University Paris V, 123 Bd de Port-Royal, 75014 Paris, France. goffinet@cochin.inserm.fr
Kayem
Gilles
G
Maillard
Françoise
F
Trébéden
Hélène
H
Cabrol
Dominique
D
Weill
Bernard
B
Batteux
Frédéric
F
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D012634:Bodily Secretions / Q000737:chemistry; D002821:Chorioamnionitis / Q000175:diagnosis; D005321:Extraembryonic Membranes; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis; D007239:Infections / Q000175:diagnosis*; D015850:Interleukin-6 / Q000032:analysis*; D007752:Obstetric Labor, Premature / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011446:Prospective Studies; D012333:RNA, Messenger; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014621:Vagina / Q000378:metabolism*; D016585:Vaginosis, Bacterial / Q000175:diagnosis
D015415:Biomarkers; D015850:Interleukin-6; D012333:RNA, Messenger