Short and inflamed cervix predicts spontaneous preterm birth (COLIBRI study)

• Published in: The journal of maternal-fetal & neonatal medicine Vol. 27; no. 10; p. 1015
• Main Authors: Raiche, Evelyne, Ouellet, Annie, Berthiaume, Maryse, Rousseau, Éric, Pasquier, Jean-Charles
• Format: Journal Article
• Language: English
• Published: England 01.07.2014
• Subjects: Adult; Biomarkers - metabolism; Cervical Length Measurement; Cervix Uteri - diagnostic imaging; Cervix Uteri - metabolism; Cervix Uteri - pathology; Cytokines - metabolism; Decision Support Techniques; Female; Humans; Interleukin-8 - metabolism; Logistic Models; Pregnancy; Premature Birth - diagnosis; Premature Birth - metabolism; Prospective Studies; Sensitivity and Specificity; Vagina - metabolism; cytokines; Cervical length; inflammation; pre-term birth; vaginal secretions; transvaginal ultrasound
• ISSN: 1476-4954
• DOI: 10.3109/14767058.2013.847917

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. 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. 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)-1β, 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. 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.