title: Cervicovaginal interleukin-6 as a predictor of preterm birth in African American women.
abstract: BACKGROUND
  Identification of women who will deliver preterm may reduce infant morbidity and mortality. In heterogeneous populations, fetal fibronectin (fFN) and interleukin-6 are excellent predictors of women who will not deliver within two weeks. African-Americans are at higher risk for preterm birth than Caucasians. This study compares the diagnostic utility of fFN and interleukin-6 in cervicovaginal fluid (CVF) to predict preterm birth within 14 days of sampling in African-American and Caucasian women.
  
  
  METHODS
  Interleukin-6 was measured in 667 CVF samples from 580 women with and without symptoms of labor. The utility of CVF interleukin-6 and fFN to predict delivery was determined in the total population and in African-Americans and Caucasians separately.
  
  
  RESULTS
  fFN positive (≥50 μg/l) results were associated with delivery in ≤14 days in African-Americans (Odds Ratios (OR) 8.7; Likelihood Ratio (LR) 3.7) (p<0.0001) and Caucasians (OR 11.9; LR 5.7) (p<0.01). A positive interleukin-6 (≥250 ng/l) was associated with delivery in ≤14 days in African-Americans (OR 12.7; LR 5.25) (p<0.0001), but not in Caucasians (OR 4.1; LR 3.2) (p=0.13).
  
  
  CONCLUSIONS
  CVF interleukin-6 and fFN have similar diagnostic utilities in a diverse population. Interleukin-6 more accurately predicts delivery within 14 days in African-Americans, while fFN is more accurate in Caucasians.
authors.affiliation: Department of Pathology, Vanderbilt University Medical Center, Nashville, TN 37232-5310, USA. Alison.Woodworth@Vanderbilt.edu
authors.forename: Alison
authors.initials: A
authors.lastname: Woodworth
authors.forename: David G
authors.initials: DG
authors.lastname: Grenache
authors.forename: Ann M
authors.initials: AM
authors.lastname: Gronowski
mesh_terms: D001741:Black or African American; D001826:Body Fluids / Q000378:metabolism*; D002584:Cervix Uteri / Q000378:metabolism*; D005260:Female; D005333:Fetus / Q000378:metabolism; D005353:Fibronectins / Q000378:metabolism; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism*; D011237:Predictive Value of Tests; D047928:Premature Birth / Q000175:diagnosis / Q000208:ethnology* / Q000378:metabolism*; D012372:ROC Curve; D014621:Vagina / Q000378:metabolism*; D044465:White People
chemical_list: D005353:Fibronectins; D015850:Interleukin-6