Noninvasive Prediction of Intra-amniotic Infection and/or Inflammation in Women With Preterm Labor: Various Cytokines in Cervicovaginal Fluid

Objective: To determine the value of cervicovaginal interleukin (IL)-1 beta, IL-6, and IL-8 in predicting intra-amniotic infection and/or inflammation (IAI) in women with preterm labor. Methods: Cervicovaginal fluid samples were collected for IL-1 beta, IL-6, and IL-8 measurements immediately before amniocentesis in 85 consecutive women with preterm labor. The IAI was defined as a positive amniotic fluid (AF) culture and/or an elevated AF IL-6 level (> 2.6 ng/mL). Results: Receiver-operating characteristic curves demonstrated that cervicovaginal IL-6 and IL-8, but not IL-1 beta, predicted IAI. Cervicovaginal IL-6 had a significantly higher area under the curve (AUC) than cervicovaginal IL-8 (P = .009). However, the AUCs for the cervicovaginal IL-6 and AF white blood cell (WBC) were not significantly different. Conclusions: Among measured cytokines, cervicovaginal IL-6 is the best marker to noninvasively identify IAI in women with preterm labor. Overall, this noninvasive parameter performed as well as AF WBC count for predicting IAI.