title: Comparative Analysis of Midtrimester Amniotic Fluid Cytokine Levels to Predict Spontaneous Very Pre-term Birth in Patients with Cervical Insufficiency.
abstract: OBJECTIVE
  Few studies have investigated the roles of cytokines and chemokines in women with cervical insufficiency, and those that have done so evaluated only a limited number of cytokines in amniotic fluid.
  
  
  METHODS
  A retrospective cohort study enrolled 71 patients undergoing physical examination-indicated cerclage to determine whether expanded amniotic fluid cytokine levels predict spontaneous very pre-term birth (≤32 weeks of gestation) in patients with cervical insufficiency. Analysis of multiple cytokines and chemokines was performed with the multiplex immunoassay.
  
  
  RESULTS
  Sixty-seven amniotic fluid samples were available for analysis and assayed for 15 cytokines. Thirty-eight (56.7%) patients delivered pre-term. Of these, 26 (38.8%) were spontaneous very pre-term births. Most cytokine levels were significantly increased in the amniotic fluid from the study group when compared with those from controls. The levels of interleukin-1β (IL-1β), IL- 6, IL- 7, IL-15, IL-17α, tumour necrosis factor-α (TNF-α), MIP-1α, and MIP-1β were higher in patients with a very pre-term delivery than in those with a late pre-term delivery. IL-1β, IL-6, IL-7, IL-17α, TNF-α, and cervical dilation were independently associated with a very pre-term birth.
  
  
  CONCLUSIONS
  Intra-amniotic inflammation may contribute to cervical insufficiency, and the severity of inflammation is associated with a very pre-term birth in women with cervical insufficiency.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Korea.
authors.forename: Ga-Hyun
authors.initials: GH
authors.lastname: Son
authors.affiliation: Medical Research Institute, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Young-Ah
authors.initials: YA
authors.lastname: You
authors.affiliation: Department of Obstetrics and Gynecology, Ewha Womans University, Seoul, Korea.
authors.forename: Eun-Jin
authors.initials: EJ
authors.lastname: Kwon
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Korea.
authors.forename: Keun-Young
authors.initials: KY
authors.lastname: Lee
authors.affiliation: Medical Research Institute, School of Medicine, Ewha Womans University, Seoul, Korea.|Department of Obstetrics and Gynecology, Ewha Womans University, Seoul, Korea.
authors.forename: Young Ju
authors.initials: YJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000276:immunology*; D016207:Cytokines / Q000276:immunology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000276:immunology*; D047928:Premature Birth / Q000276:immunology*; D012189:Retrospective Studies; D002581:Uterine Cervical Incompetence / Q000276:immunology*
chemical_list: D016207:Cytokines
keywords: Amniotic fluid; cervical insufficiency; cytokine