Short and inflamed cervix predicts spontaneous preterm birth (COLIBRI study).
OBJECTIVE
To develop a new strategy of predicting spontaneous preterm birth (sPTB) by combination of transvaginal ultrasound (TVUS) assessment and inflammatory proteins detection in vaginal secretions.


METHODS
Prospective study of 87 women referred for cervical length assessment with a standardized TVUS combined to vaginal secretions sampling. Samples were analyzed for presence of 10 cytokines. Main outcome was sPTB (<37 weeks of gestation). Associations were assessed with the chi-square, Fisher's exact test (p < 0.05) and Wald's logistic regression.


RESULTS
sPTB occurred in 25.3% of women at a median gestational age of 35.6 weeks of gestation. Short cervix (<25 mm) (n = 24) was associated with sPTB (p < 0.01) as interleukine (IL)-1β, IL-8 and IL-10 in vaginal secretions (p < 0.05). In multivariate analysis, short cervix and IL-8 in vaginal secretions were independently associated with sPTB (OR 3.58 (95%CI 1.02; 12.61) and 14.55 (95%CI 1.64; 128.83), respectively) as their combination (OR 4.33 (95%CI 1.25; 14.95)). By categorizing cervical length by presence of IL-8, sPTB occurred in 55.6% of women with a short inflamed cervix.


CONCLUSIONS
COLIBRI study used a novel, single-step method of vaginal secretions sampling during TVUS and demonstrated that combination of short cervix and IL-8 in vaginal secretions is a promising sPTB predictive test.
Department of Obstetrics and Gynecology .
Evelyne
E
Raiche
Annie
A
Ouellet
Maryse
M
Berthiaume
Éric
É
Rousseau
Jean-Charles
JC
Pasquier
D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D054791:Cervical Length Measurement; D002584:Cervix Uteri / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D016207:Cytokines / Q000378:metabolism*; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D016209:Interleukin-8 / Q000378:metabolism; D016015:Logistic Models; D011247:Pregnancy; D047928:Premature Birth / Q000175:diagnosis* / Q000378:metabolism; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014621:Vagina / Q000378:metabolism*
D015415:Biomarkers; D016207:Cytokines; D016209:Interleukin-8
Cervical length; cytokines; inflammation; pre-term birth; transvaginal ultrasound; vaginal secretions