Interplay of cytokine polymorphisms and bacterial vaginosis in the etiology of preterm delivery.
Recent findings suggest that the association between inflammation-related genes and preterm delivery may be stronger in the presence of bacterial vaginosis (BV). Tumor necrosis factor-alpha (TNFα) and interleukin 1-beta (IL-1β) are pro-inflammatory cytokines capable of inducing preterm labor in non-human primates. In this study the authors tested associations among two TNFα promoter polymorphisms (-G308A and -G238A), a single IL-1β polymorphism (+C3954T), vaginal microbial findings, and risk of preterm delivery. Data were from the Pregnancy Outcomes and Community Health (POUCH) Study (n=777 term and n=230 preterm deliveries). Vaginal smears collected at mid-pregnancy (15-27 weeks gestation) were scored according to Nugent's criteria. A Nugent score of ≥ 4 was modeled as the cut-point for intermediate and positive BV. Logistic regression was used to estimate odds ratios for associations among independent covariates (vaginal flora, genotype) and preterm delivery. Results showed that women with a Nugent score of≥ 4 and the TNFα -238 A/G or A/A were at increased risk of delivering preterm (race/ethnicity adjusted OR 2.6, 95% CI 1.2, 5.8). The p-value for the genotype and Nugent score interaction=0.02. This study points to one more example of a potential gene-environment interaction in a preterm delivery pathway. Future tests of this finding will determine the robustness of these results.
Department of Epidemiology, B601 West Fee Hall, Michigan State University, East Lansing, MI 48824, USA. njones@epi.msu.edu
Nicole M
NM
Jones
Claudia
C
Holzman
Karen H
KH
Friderici
Katherine
K
Jernigan
Hwan
H
Chung
Julia
J
Wirth
Rachel
R
Fisher
D000328:Adult; D015331:Cohort Studies; D016207:Cytokines; D005260:Female; D005838:Genotype; D006801:Humans; D053583:Interleukin-1beta / Q000235:genetics; D020641:Polymorphism, Single Nucleotide; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000209:etiology* / Q000235:genetics / Q000382:microbiology; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics*; D014621:Vagina / Q000382:microbiology; D016585:Vaginosis, Bacterial / Q000150:complications*; D055815:Young Adult
D016207:Cytokines; D053583:Interleukin-1beta; D014409:Tumor Necrosis Factor-alpha