The authors have stated explicitly that there are no conflicts of interest in connection with this article.
Main Research Article
Predictive value of combined cervicovaginal cytokines and gestational age at sampling for intra-amniotic infection in preterm premature rupture of membranes
Article first published online: 9 FEB 2013
© 2013 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2013 Nordic Federation of Societies of Obstetrics and Gynecology
Acta Obstetricia et Gynecologica Scandinavica
Volume 92, Issue 5, pages 517–524, May 2013
How to Cite
Predictive value of combined cervicovaginal cytokines and gestational age at sampling for intra-amniotic infection in preterm premature rupture of membranes. Acta Obstet Gynecol Scand 2013; 92: 517–524., , , , , .
- Issue published online: 17 APR 2013
- Article first published online: 9 FEB 2013
- Accepted manuscript online: 17 JAN 2013 06:57AM EST
- Manuscript Accepted: 13 DEC 2012
- Manuscript Received: 13 MAR 2012
- Seoul National University College of Medicine Research Foundation
- Amniotic fluid;
- cervicovaginal fluid;
- intra-amniotic infection;
- preterm premature rupture of membrane
To determine whether interleukin (IL)-1β, IL-6, and IL-8 in cervicovaginal fluid, alone or in combination with clinical risk factors, could predict intra-amniotic infection in women with preterm premature rupture of membranes (PPROM).
A prospective cohort study.
University teaching hospital.
Women with singleton pregnancies presenting PPROM between 20 and 35 weeks of gestation (n = 76).
Cervicovaginal fluid samples were collected for IL-1β, IL-6, and IL-8 measurements immediately before amniocentesis. Amniotic fluid obtained by amniocentesis was cultured and the white blood cell count was determined. Clinical risk factors analyzed included demographics and gestational age. Cervicovaginal concentrations of cytokines were measured using a multiplex bead array assay.
Main outcome measure
A positive amniotic fluid culture.
The prevalence of a positive amniotic fluid culture was 46.1% (35/76). Stepwise multivariate regression analysis yielded a model using cervicovaginal IL-6 and gestational age at sampling with the area under the curve (AUC) of 0.807 for predicting intra-amniotic infection. The AUC for this model was significantly higher than either parameter retained in this model but no differences were observed between the AUC of this model based on non-invasive variables, and amniotic fluid white blood cell count using invasive amniocentesis for the prediction of intra-amniotic infection.
Among measured cytokines, the combination of cervicovaginal IL-6 and gestational age appears to be best in predicting intra-amniotic infection and allows for a considerably better accuracy than the use of either factor alone. Overall, this combination performed as well as amniotic fluid WBC count for predicting intra-amniotic infection.