title: Early second-trimester inflammatory markers and short cervical length and the risk of recurrent preterm birth.
abstract: This study aimed to analyze the associations between serum and cervicovaginal inflammatory markers and recurrent spontaneous preterm birth in a cohort study of 62 pregnant women with > or =1 prior early spontaneous birth. Serum samples and cervicovaginal swabs from the women were obtained at enrollment in early second trimester (week 12-25). Cervical length was measured by ultrasound and dicotomized in to short (< or =25 mm) and long cervices (>25 mm). The study endpoints were spontaneous preterm birth before 35 weeks and secondarily<37 weeks. Multiple inflammatory markers in serum (IL-1beta, IL-2, IL-5, IL-6, IL-8, IL-12, IL-18, TNF-alpha, TGF-beta, sTNF-R1, GM-CSF and TREM-1) and cervicovaginal secretions (IL-18, sTNF-RI and sIL-6) were individually associated with spontaneous preterm birth. Short cervical length did not explain associations between inflammatory markers and spontaneous preterm birth. Serum and cervicovaginal inflammatory markers did not correlate. In a combined prediction model using both serum and vaginal inflammatory markers, serum TNF-alpha, cervicovaginal sIL-6Ralpha and cervical length predicted 69% of all recurrent spontaneous preterm birth at a 5% false-positive rate. In conclusion, cervical length, serum TNF-alpha and cervicovaginal sIL-6Ralpha provide a clinically useful prediction of recurrent preterm birth in early second-trimester in women with a prior spontaneous preterm birth.
authors: NANEA, Institute for Public Health, University of Aarhus, Denmark; Department of Clinical Genetics, Aarhus University Hospital, Denmark. iv@soci.au.dk
authors: Ida
authors: I
authors: Vogel
authors: Alice R
authors: AR
authors: Goepfert
authors: Poul
authors: P
authors: Thorsen
authors: Kristin
authors: K
authors: Skogstrand
authors: David M
authors: DM
authors: Hougaard
authors: Allison H
authors: AH
authors: Curry
authors: Suzanne
authors: S
authors: Cliver
authors: William W
authors: WW
authors: Andrews
mesh_terms: D000293:Adolescent; D000328:Adult; D016207:Cytokines / Q000032:analysis* / Q000096:biosynthesis / Q000097:blood; D005260:Female; D006801:Humans; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000276:immunology; D002581:Uterine Cervical Incompetence
chemical_list: D016207:Cytokines