title: Inflammatory and infectious risk factors are associated with the response to tocolysis in patients with preterm labor.
abstract: OBJECTIVE
  Inflammation/infection is the most frequent conditions leading to preterm delivery (PTD). A few studies have assessed the clinical efficacy of long-term tocolysis with ritodrine hydrochloride. In this study, the relationship among inflammatory/infective risk factors of PTD, the response to long-term tocolysis, and timing of delivery were evaluated in women with preterm labor.
  
  
  METHODS
  On the basis of different responses to long-term tocolysis, defined as ≥ 7 days tocolysis, the cohort were classified as: (i) patients delivering at term (Group A) and (ii) patients delivering preterm (group B). Group B was subclassified as: (i) delivery before 48 h (group B1); (ii) delivery between 48 h and 7 days (Group B2), and (iii) delivery after 7 days (Group B3). Group B is divided in early preterm (<32 weeks) (Group B early) and late PTD (32-36 weeks) (Group B late).
  
  
  RESULTS
  Group A delivered at term and Group B preterm. Group B showed significantly higher (p < 0.0001) rate of CRP, bacterial vaginosis, and chorioamnionitis at placental histological examination than Group A. The same parameters were statistically higher (p < 0.0001) in group B1 than in B3. CRP, chorioamnionitis at placental histological examination was statistically higher (p < 0.0001) in Group B early than in Group B late.
  
  
  CONCLUSIONS
  This retrospective study suggested that in women affected by preterm labor, the long-term tocolysis with intravenous ritodrine is able to prolong gestation beyond 7 days, in absence of inflammatory/infective risk factors of PTD.
authors.affiliation: Department of Pediatrics, University of Siena, Siena, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Torricelli
authors.forename: Chiara
authors.initials: C
authors.lastname: Voltolini
authors.forename: Nathalie
authors.initials: N
authors.lastname: Conti
authors.forename: Maria
authors.initials: M
authors.lastname: De Bonis
authors.forename: Giulia
authors.initials: G
authors.lastname: Biliotti
authors.forename: Enrico
authors.initials: E
authors.lastname: Picciolini
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007752:Obstetric Labor, Premature / Q000188:drug therapy / Q000276:immunology*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D012312:Ritodrine / Q000627:therapeutic use*; D013997:Time Factors; D015145:Tocolysis; D015149:Tocolytic Agents / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D015149:Tocolytic Agents; D012312:Ritodrine