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Microbiological characteristics and inflammatory cytokines associated with preterm labor

  • Materno-fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To evaluate vaginal microflora and interleukin-1β (IL-β), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor-alpha (TNF-α) concentrations in the cervicovaginal fluid of a group of pregnant women in preterm labor when compared with a group of full-term pregnant women not yet in labor.

Method

Case–control study performed in a University tertiary referral maternity in Campinas, Brazil with 45 pregnant women in preterm labor and 45 full-term pregnant women not in labor. All patients underwent speculum examination for the collection of cervicovaginal fluid. Bacterial vaginosis (BV) was diagnosed according to the criteria of Amsel and Nugent. Culture was performed for group B streptococcus (GBS) and lactobacilli, and hybrid capture assay for screening for chlamydial and gonococcal infection. Cytokine concentrations were measured using ELISA technique. Statistical analysis was performed using χ2, Fisher’s exact, and crude and adjusted odds ratios. Significance level was defined at 5%. The main outcome measures were cervicovaginal cytokines in preterm labor.

Results

IL-6 and IL-8 were significantly associated with preterm labor. The changes in vaginal microflora, as well as BV and GBS, were more frequent in women in preterm labor, although BV and GBS showed no statistical significance. The presence of Candida sp., absence of lactobacilli, positive screening for chlamydial and gonococcal infection and the presence of IL-1β and TNF-α were not associated with preterm labor.

Conclusions

IL-6 and IL-8 and the presence of any type of vaginal infection were the factors that were significantly associated with preterm labor.

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Abbreviations

BMI:

Body mass index

BV:

Bacterial vaginosis

CI:

Confidence interval

CT:

Chlamydia trachomatis

GBS:

Group B Streptococcus

IL:

Interleukin

LPS:

Lipopolysaccharide

NG:

Neisseria gonorrhea

OR:

Odds ratio

PBS:

Phosphate buffered saline

RLU:

Relative light unit

TNF-α:

Tumor necrosis factor-alpha

UNICAMP:

University of Campinas

UTI:

Urinary tract infection

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Acknowledgments

The authors gratefully acknowledge the collaboration of Jossimara Polettini in performing the ELISA tests, Andréia Leal for her help in providing care for the patients included in the study and Sirlei Morais for collaborating in the statistical analysis. The financial support of the São Paulo Foundation for the Support of Research (FAPESP) is also gratefully acknowledged. Unfortunately, after the end of this study, Prof. J.A. Simoes died. All the authors would like to recognize his leadership in this topic.

Conflict of interest statement

None.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade Estadual De Campinas, Campinas, SP, Brazil

    Michelle G. Discacciati, Eliane Brolazo, Maria L. Costa & Jose G. Cecatti

  2. Department of Pathology, Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP), Botucatu, Brazil

    Marcia G. Silva & Camila Marconi

Authors
  1. Michelle G. Discacciati
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  2. Jose A. Simoes
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  3. Marcia G. Silva
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  4. Camila Marconi
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  5. Eliane Brolazo
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  6. Maria L. Costa
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  7. Jose G. Cecatti
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Corresponding author

Correspondence to Jose G. Cecatti.

Additional information

Deceased: Jose A. Simoes.

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Discacciati, M.G., Simoes, J.A., Silva, M.G. et al. Microbiological characteristics and inflammatory cytokines associated with preterm labor. Arch Gynecol Obstet 283, 501–508 (2011). https://doi.org/10.1007/s00404-010-1427-z

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  • DOI: https://doi.org/10.1007/s00404-010-1427-z

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