Microbial invasion and cytokine response in amniotic fluid in a Swedish population of women in preterm labor

• Published in: Acta obstetricia et gynecologica Scandinavica Vol. 82; no. 2; pp. 120 - 128
• Main Authors: Jacobsson, Bo, Mattsby-Baltzer, Inger, Andersch, Björn, Bokström, Hans, Holst, Rose-Marie, Wennerholm, Ulla-Britt, Hagberg, Henrik
• Format: Journal Article
• Language: English
• Published: Oxford, UK Munksgaard International Publishers 01.02.2003; Taylor & Francis
• Subjects: Adult; Amniocentesis; Amniotic Fluid - metabolism; Amniotic Fluid - microbiology; Biological and medical sciences; Chorioamnionitis - metabolism; Chorioamnionitis - microbiology; Diseases of mother, fetus and pregnancy; Female; Gynecology. Andrology. Obstetrics; Humans; interleukin-6; Interleukin-6 - metabolism; interleukin-8; Interleukin-8 - metabolism; Medical sciences; microbial invasion; Obstetric Labor, Premature; Predictive Value of Tests; Pregnancy; Pregnancy Complications, Infectious - metabolism; Pregnancy Complications, Infectious - microbiology; Pregnancy Outcome; Pregnancy. Fetus. Placenta; preterm birth; preterm labor; ROC Curve; Survival Analysis; Sweden; Sweden; Human; preterm birth; Pregnancy disorders; Cytokine; Premature delivery; preterm labor; Inflammation; interleukin-8; Bacteriological investigation; interleukin-6; Infection; Interleukin 6; Polymerase chain reaction; Microbiological investigation; microbial invasion; Amniotic fluid; Risk factor; Amniotic fluid disorders; Delivery disorders; Fetus; Molecular biology; Comparative study; Interleukin 8
• ISSN: 0001-6349; 1600-0412
• DOI: 10.1034/j.1600-0412.2003.00047.x

Background. Previous studies indicate an association between intra‐amniotic microbial invasion and/or inflammation and spontaneous preterm birth, but there is a limited amount of data available from Europe. The aim of this study was to investigate the occurrence of intra‐amniotic microorganisms and cytokines (interleukin‐6 and interleukin‐8) in a Swedish population of women in preterm labor and their correlation with preterm birth. Methods. Amniotic fluid was retrieved transabdominally from 61 patients in preterm labor before 34 weeks of gestation. Polymerase chain reaction analyses for Ureaplasma urealyticum and Mycoplasma hominis and culture for aerobic and anaerobic bacteria were performed. Interleukin‐6 and interleukin‐8 were analyzed with enzyme‐linked immunosorbent assay. Results. Microorganisms in amniotic fluid were detected in 10 patients (16%). Patients with detected bacteria in the amniotic fluid had significantly higher levels of interleukin‐6 and interleukin‐8. There was also an association between interleukin‐6/‐8, the amniocentesis‐delivery interval (≤ 7 days) and preterm birth (<34 weeks). An amniotic fluid concentration of interleukin‐6 ≥ 1.5 ng/mL or interleukin‐8 ≥ 1.3 ng/mL was associated with an increased risk of delivery within 7 days (interleukin‐6: relative risk 7.3; 95% confidence interval: 2.8–19; sensitivity 83%, specificity 87%; interleukin‐8: relative risk 14, 95% confidence interval: 3.6–55, sensitivity 91%, specificity 87%). Conclusions. The occurrence of intra‐amniotic microbial invasion and inflammation in this population of Swedish women in preterm labor was similar to data reported from populations with a higher incidence of preterm delivery. Amniotic interleukin‐6 and interleukin‐8 correlated with the presence of microorganisms and with preterm birth.