title: Prediction of impending preterm delivery based on sonographic cervical length and different cytokine levels in cervicovaginal fluid in preterm labor.
abstract: OBJECTIVE
  The aim of this study was to determine whether cervicovaginal interleukin (IL)-1β, IL-6 and IL-8 levels, and cervical length, alone or in combination, could predict impending preterm delivery in women with preterm labor and intact membranes.
  
  
  METHODS
  Cervicovaginal swab samples for IL-1β, IL-6, and IL-8 assays were taken from 136 consecutive women with preterm labor (23-34 weeks) before the transvaginal ultrasonography examination to measure cervical length. The primary outcome measurement was spontaneous preterm delivery within 7 days of sampling.
  
  
  RESULTS
  Spontaneous preterm delivery within 7 days occurred in 28.6% (39/136) of patients. Receiver-operator characteristic (ROC) curves indicated that cervical length (P < 0.001), cervicovaginal IL-6 (P < 0.001) and IL-8 (P = 0.014), but not IL-1β, could predict delivery within 7 days. According to the logistic regression analysis, high cervicovaginal IL-8 (P = 0.008) and IL-6 (P = 0.038) levels and short cervical length (P < 0.001) were significantly associated with delivery within 7 days, even after controlling for baseline variables. A combination of cervix length and cervicovaginal IL-8 increased the specificity of detecting delivery within 7 days to 92.8%, which was superior to either test alone (P < 0.001), but the sensitivity was only 56.4%.
  
  
  CONCLUSIONS
  In women with preterm labor, among the parameters assessed, cervicovaginal IL-6 and IL-8 and cervical length are the most important parameters in predicting impending preterm delivery. A combination of cervix length and cervicovaginal IL-8 appeared to be the best for predicting impending preterm delivery, but the relatively low sensitivity of this test may limit its clinical usefulness.
authors.affiliation: Departments of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University, Bundang Hospital, Seongnam.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Jung
authors.affiliation: Department of Obstetrics and Gynecology, Inje University College of Medicine, Ilsan-Paik Hospital, Gyeonggi, South Korea.
authors.forename: Jeong Woo
authors.initials: JW
authors.lastname: Park
authors.affiliation: Departments of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University, Bundang Hospital, Seongnam.
authors.forename: Aeli
authors.initials: A
authors.lastname: Ryu
authors.affiliation: Departments of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University, Bundang Hospital, Seongnam.
authors.forename: Sung Youn
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Departments of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University, Bundang Hospital, Seongnam.
authors.forename: Soo-Hyun
authors.initials: SH
authors.lastname: Cho
authors.affiliation: Departments of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University, Bundang Hospital, Seongnam.
authors.forename: Kyo Hoon
authors.initials: KH
authors.lastname: Park
mesh_terms: D000328:Adult; D054791:Cervical Length Measurement; D002584:Cervix Uteri / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D006801:Humans; D053583:Interleukin-1beta / Q000032:analysis; D015850:Interleukin-6 / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D007378:Interleukins / Q000032:analysis*; D047928:Premature Birth / Q000175:diagnosis*; D012372:ROC Curve; D016216:Ultrasonography, Prenatal; D014621:Vagina / Q000000981:diagnostic imaging / Q000378:metabolism*; D014626:Vaginal Smears
chemical_list: D053583:Interleukin-1beta; D015850:Interleukin-6; D016209:Interleukin-8; D007378:Interleukins
keywords: cervical length; cervicovaginal fluid; impending preterm delivery; interleukin; preterm labor