期刊
JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
卷 27, 期 10, 页码 1015-1019出版社
TAYLOR & FRANCIS LTD
DOI: 10.3109/14767058.2013.847917
关键词
Cervical length; cytokines; inflammation; pre-term birth; transvaginal ultrasound; vaginal secretions
Objective: To develop a new strategy of predicting spontaneous preterm birth (sPTB) by combination of transvaginal ultrasound (TVUS) assessment and inflammatory proteins detection in vaginal secretions. Methods: Prospective study of 87 women referred for cervical length assessment with a standardized TVUS combined to vaginal secretions sampling. Samples were analyzed for presence of 10 cytokines. Main outcome was sPTB (<37 weeks of gestation). Associations were assessed with the chi-square, Fisher's exact test (p<0.05) and Wald's logistic regression. Results: sPTB occurred in 25.3% of women at a median gestational age of 35.6 weeks of gestation. Short cervix (<25 mm) (n = 24) was associated with sPTB (p<0.01) as interleukine (IL)-1 beta, IL-8 and IL-10 in vaginal secretions (p<0.05). In multivariate analysis, short cervix and IL-8 in vaginal secretions were independently associated with sPTB (OR 3.58 (95%CI 1.02; 12.61) and 14.55 (95%CI 1.64; 128.83), respectively) as their combination (OR 4.33 (95%CI 1.25; 14.95)). By categorizing cervical length by presence of IL-8, sPTB occurred in 55.6% of women with a short inflamed cervix. Conclusion: COLIBRI study used a novel, single-step method of vaginal secretions sampling during TVUS and demonstrated that combination of short cervix and IL-8 in vaginal secretions is a promising sPTB predictive test.
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