title: Mid-trimester cervical inflammatory milieu and sonographic cervical length.
abstract: OBJECTIVE
  The purpose of this study was to explore the relation between the relative balance of pro- and antiinflammatory cytokines in cervical fluid and mid-trimester cervical length.
  
  
  METHODS
  In this prospective longitudinal cohort of women with a previous spontaneous preterm birth, mid-trimester cervical length ultrasound scans and cervical fluid levels were obtained serially. Multiple pro- and antiinflammatory cytokines were selected. We summed the multiples of the median for proinflammatory cytokines to generate the proinflammatory and the antiinflammatory scores. The relation between cervical length and pro-/antiinflammatory ratio was assessed by generalized estimating equations.
  
  
  RESULTS
  The pro-/antiinflammatory ratio had a negative linear association with cervical length (beta = -0.09; P < .001). Sixty percent of visits demonstrated greater concentrations of proinflammatory cytokines relative to antiinflammatory cytokines. This relationship did not change between first and last visits.
  
  
  CONCLUSIONS
  Among women with a previous preterm birth, shorter mid-trimester cervical length is associated with a more proinflammatory balance of cytokines in the cervical inflammatory milieu.
authors.affiliation: Department of Obstetrics and Gynecology, Magee Womens Hospital, Pittsburgh, PA 15213, USA.
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Kalan
authors.forename: Hyagriv N
authors.initials: HN
authors.lastname: Simhan
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000000981:diagnostic imaging* / Q000473:pathology; D015331:Cohort Studies; D016207:Cytokines / Q000032:analysis / Q000378:metabolism*; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis / Q000378:metabolism*; D016014:Linear Models; D008137:Longitudinal Studies; D010298:Parity; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D018566:Pregnancy, High-Risk; D047928:Premature Birth / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000517:prevention & control; D011295:Prenatal Care; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D016216:Ultrasonography, Prenatal / Q000379:methods; D002581:Uterine Cervical Incompetence / Q000000981:diagnostic imaging / Q000378:metabolism; D055815:Young Adult
chemical_list: D016207:Cytokines; D018836:Inflammation Mediators