title: Comprehensive amniotic fluid cytokine profile evaluation in women with a short cervix: which cytokine(s) correlates best with outcome?
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, New York University Medical Center, New York, NY, USA.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Keeler
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Kiefer
authors.forename: Orion A
authors.initials: OA
authors.lastname: Rust
authors.forename: Anthony
authors.initials: A
authors.lastname: Vintzileos
authors.forename: Robert O
authors.initials: RO
authors.lastname: Atlas
authors.forename: Eran
authors.initials: E
authors.lastname: Bornstein
authors.forename: Nazeeh
authors.initials: N
authors.lastname: Hanna
mesh_terms: 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
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2; D016207:Cytokines