Comprehensive amniotic fluid cytokine profile evaluation in women with a short cervix: which cytokine(s) correlates best with outcome?
OBJECTIVE
The objective of this study was to determine whether an expanded amniotic fluid cytokine profile predicts spontaneous preterm birth in patients with short cervix in the midtrimester.


METHODS
Amniocentesis was performed on singleton gestations between 16-24 weeks with a cervical length <or=25 mm. Amniotic fluid from patients who received no surgical or hormonal treatment was assayed for 25 cytokines. Univariate analysis identified cytokine(s) that correlated with the interval between amniocentesis to delivery. Stepwise regression identified which cytokine(s) was most predictive of delivery, followed by the generation of receiver-operator characteristic curves. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated.


RESULTS
Forty-four amniotic fluid samples were analyzed. After stepwise regression, only monocyte chemotactic protein-1 remained significant and was the most predictive of early delivery. With a cutoff of 1320 pg/mL, monocyte chemotactic protein-1 had a 69% sensitivity, 83% specificity, 36% positive predictive value, and 87% negative predictive value to predict spontaneous preterm birth within 1 week of amniocentesis (P = .015).


CONCLUSIONS
Among 25 cytokines, monocyte chemotactic protein-1 was most predictive of spontaneous preterm birth.
Keeler
Sean M
SM
Department of Obstetrics and Gynecology, New York University Medical Center, New York, NY, USA.
Kiefer
Daniel G
DG
Rust
Orion A
OA
Vintzileos
Anthony
A
Atlas
Robert O
RO
Bornstein
Eran
E
Hanna
Nazeeh
N
D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry*; D002584:Cervix Uteri / Q000000981:diagnostic imaging / Q000473:pathology*; D018932:Chemokine CCL2 / Q000032:analysis; D016207:Cytokines; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000378:metabolism*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D055815:Young Adult
C111835:CCL2 protein, human; D018932:Chemokine CCL2; D016207:Cytokines