title: Maternal serum cytokines in preterm premature rupture of membranes.
abstract: OBJECTIVE
  To estimate whether maternal serum interleukin (IL)-6 or granulocyte colony-stimulating factor (G-CSF) obtained daily are elevated in women with preterm premature rupture of membranes who develop funisitis.
  
  
  METHODS
  Daily blood samples were obtained from women with preterm premature rupture of membranes and analyzed for IL-6 and G-CSF by enzyme-linked immunosorbent assay. Funisitis was determined by placental examination. Observations were stratified based on the presence or absence of funisitis and analyzed. Proportional hazards models were used to evaluate time-to-delivery on the basis of diagnostic IL-6 and G-CSF levels, determined by receiver operating characteristic curve analysis.
  
  
  RESULTS
  Of the 107 patients available for analysis, 54 (50%) had evidence of funisitis after delivery. Patients with funisitis were more likely to deliver at an earlier gestational age (28.5 weeks compared with 31.5 weeks, P<.001) and have Medicaid insurance (57% compared with 39%, P=.04). Serum IL-6 and G-CSF were elevated 24 to 48 hours before delivery in women with preterm premature rupture of membranes with funisitis compared with those without funisitis (IL-6, 7.5 compared with 2.8 pg/mL, P<.001; G-CSF, 121.7 compared with 56.9 pg/mL, P=.002). Using values identified by the receiver operating characteristic curve, elevated serum IL-6 in the interval 24-72 hours before delivery was significantly associated with funisitis (P<.03), even after controlling for gestational age and insurance status.
  
  
  CONCLUSIONS
  Maternal serum IL-6 and G-CSF appear to be biomarkers in the identification of women with preterm premature rupture of membranes likely to develop funisitis.
  
  
  METHODS
  II.
authors.affiliation: Department of Obstetrics and Gynecology and Center for Human Genetics, Duke University Medical Center, Durham, NC 27710, USA. murth002@mc.duke.edu
authors.forename: Amy P
authors.initials: AP
authors.lastname: Murtha
authors.forename: Tammy
authors.initials: T
authors.lastname: Sinclair
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Hauser
authors.forename: Geeta K
authors.initials: GK
authors.lastname: Swamy
authors.forename: William N P
authors.initials: WN
authors.lastname: Herbert
authors.forename: R Phillips
authors.initials: RP
authors.lastname: Heine
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002821:Chorioamnionitis / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000097:blood*; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D010920:Placenta / Q000473:pathology; D011247:Pregnancy
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D016179:Granulocyte Colony-Stimulating Factor