title: Differences in inflammatory markers between nulliparous women admitted to hospitals in preactive vs active labor.
abstract: OBJECTIVE
  To determine whether labor-associated inflammatory markers differ between low-risk, nulliparous women in preactive vs active labor at hospital admission and over time.
  
  
  METHODS
  Prospective comparative study of low-risk, nulliparous women with spontaneous labor onset at term (n = 118) sampled from 2 large Midwestern hospitals. Circulating concentrations of inflammatory markers were measured at admission and again 2 and 4 hours later: namely, neutrophil, and monocyte counts; and serum inflammatory cytokines (interleukin -1β, interleukin-6, tumor necrosis factor-α, interleukin-10) and chemokines (interleukin-8). Biomarker concentrations and their patterns of change over time were compared between preactive (n = 63) and active (n = 55) labor admission groups using Mann-Whitney U tests.
  
  
  RESULTS
  Concentrations of interleukin-6 and interleukin-10 in the active labor admission group were significantly higher than concentrations in the preactive labor admission group at all 3 time points. Neutrophil levels were significantly higher in the active group at 2 and 4 hours after admission. The rate of increase in neutrophils and interleukin-10 between admission and 2 hours later was faster in the active group (P < .001 and P = .003, respectively).
  
  
  CONCLUSIONS
  Circulating concentrations of several inflammatory biomarkers are higher and their rate of change over time since admission is faster among low-risk, nulliparous women admitted to hospitals in active labor, as compared with those admitted in preactive labor. More research is needed to determine if progressive changes in inflammatory biomarkers might be a useful adjunct to improving the assessment of labor progression and determining the optimal timing of labor admission.
authors.affiliation: School of Nursing, Vanderbilt University, Nashville, TN. Electronic address: jeremy.neal@vanderbilt.edu.
authors.forename: Jeremy L
authors.initials: JL
authors.lastname: Neal
authors.affiliation: Department of Women's Health Services, Riverside Methodist Hospital, Columbus, OH.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Lamp
authors.affiliation: College of Nursing, University of Colorado Denver, Aurora, CO.
authors.forename: Nancy K
authors.initials: NK
authors.lastname: Lowe
authors.affiliation: College of Nursing, The Ohio State University, Columbus, OH.
authors.forename: Shannon L
authors.initials: SL
authors.lastname: Gillespie
authors.affiliation: College of Nursing, The Ohio State University, Columbus, OH.
authors.forename: Loraine T
authors.initials: LT
authors.lastname: Sinnott
authors.affiliation: College of Nursing, Marquette University, Milwaukee, WI.
authors.forename: Donna O
authors.initials: DO
authors.lastname: McCarthy
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D007378:Interleukins / Q000097:blood*; D007745:Labor Onset / Q000097:blood*; D010298:Parity; D010343:Patient Admission; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha
keywords: cytokines; inflammation; interleukins; labor onset; nulliparity
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