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.
Jones
Nicole M
NM
Department of Epidemiology, B601 West Fee Hall, Michigan State University, East Lansing, MI 48824, USA. njones@epi.msu.edu
Holzman
Claudia
C
Friderici
Karen H
KH
Jernigan
Katherine
K
Chung
Hwan
H
Wirth
Julia
J
Fisher
Rachel
R
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