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Comparative Analysis of Midtrimester Amniotic Fluid Cytokine Levels to Predict Spontaneous Very Pre-term Birth in Patients with Cervical Insufficiency
- Comparative Analysis of Midtrimester Amniotic Fluid Cytokine Levels to Predict Spontaneous Very Pre-term Birth in Patients with Cervical Insufficiency
- Son, Ga-Hyun; You, Young-Ah; Kwon, Eun-Jin; Lee, Keun-Young; Kim, Young Ju
- Ewha Authors
- 김영주; 유영아
- SCOPUS Author ID
- 김영주; 유영아
- Issue Date
- Journal Title
- AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY
- 1046-7408; 1600-0897
- vol. 75, no. 2, pp. 155 - 161
- Amniotic fluid; cervical insufficiency; cytokine
- SCI; SCIE; SCOPUS
- Problem 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. Method of study 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-1 beta (IL-1 beta), IL-6, IL-7, IL-15, IL-17 alpha, tumour necrosis factor-alpha (TNF-alpha), MIP-1 alpha, and MIP-1 beta were higher in patients with a very pre-term delivery than in those with a late pre-term delivery. IL-1 beta, IL-6, IL-7, IL-17 alpha, TNF-alpha, and cervical dilation were independently associated with a very pre-term birth. Conclusion 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.
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