Proinflammatory cytokines and other indications of inflammation in cervico-vaginal secretions and preterm delivery

Objectives: To compare the usefulness of evaluating cervico-vaginal concentrations of proinflammatory cytokines (interleukin [IL]-1alpha, IL-1beta, IL-6 and IL-8) and procalcitonin (PCT), as well as serum levels of C-reactive protein (CRP), leucocytosis and band form granulocytes in the prediction of preterm delivery (PTD). Methods: A total of 65 pregnant women experiencing preterm labor (PTL) were enrolled in the study. Concentrations of the studied markers in women who delivered prematurely and in women who, after treatment, delivered at term were compared. Receiver operator characteristic (ROC) curve analysis was used for all study parameters. Results: Cervico-vaginal IL-6 and procalcitonin as well as serum CRP concentrations were higher in women who delivered prematurely than in those who delivered near term. A cervico-vaginal IL-6 level greater than 660pg/ml was the best predictive value of preterm delivery (sensitivity, 50%; specificity 90%; positive predictive value [PPV], 85%; NPV, 62%; likelihood ratio, 5.17). Moreover, the area under the ROC curve of 0.75 for cervico-vaginal IL-6 was greater than for other markers. Conclusion: Although cervico-vaginal concentrations of procalcitonin and serum concentration of CRP are higher in women who deliver prematurely, only cervico-vaginal concentration of IL-6 is a good predictor of preterm delivery. (C) 2004 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.