Abstract
OBJECTIVE: The human fetus is thought to signal preterm parturition in the setting of infection by the production of pro-inflammatory cytokines (II.-1β and IL-6), which in turn stimulate prostaglandin production leading up to myometrial contractions. The objective of this study was to determine the frequency and characteristics of the fetal cytokine response in patients presenting with preterm labor and intact membranes. STUDY DESIGN: Amniocentesis and cordocentesis were performed in 107 patients with preterm labor and intact membranes. Written informed consent and multi-institutional IRB approval were obtained. Amniotic fluid was cultured for aerobic and anaerobic bacteria. IL-1β and IL-6 were measured by specific immunoassays. Statistical analysis included contingency tables, ROC curve and survival analysis with Cox proportional hazard modeling. RESULTS: 1) Fetal plasma IL-1β and IL-6 were significantly higher in patients with positive amniotic fluid cultures than in those with negative cultures (IL-1β: median 9.01 pg/ml, range 2.21-115.46 vs. median 3.79pg/ml, range 0.88-30.29, respectively, p<0.05; IL-6: median 34.05 pg/ml, range 0.71-762 vs. median 5.65, range 0-741, respectively, p<0.01; 2) the proportion of fetuses with a systemic cytokine response (defined as a fetal plasma IL-6 ≥ 18 pg/ml) was 69.2% (9/13) in fetuses with positive amniotic fluid culture and 11.7% (11/94) in those with negative amniotic fluid culture. CONCLUSIONS: 1 ) Fetuses with preterm labor and intraamniotic infection have a demonstrable systemic cytokine response; 2) Fetal sepsis may be more common than traditionally recognized by standard clinical microbiologic techniques.
Original language | English |
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Pages (from-to) | S14 |
Journal | Acta Diabetologica Latina |
Volume | 176 |
Issue number | 1 PART II |
State | Published - 1 Dec 1997 |
Externally published | Yes |
ASJC Scopus subject areas
- Internal Medicine
- Endocrinology, Diabetes and Metabolism
- Endocrinology