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Mid-pregnancy circulating cytokine levels, histologic chorioamnionitis and spontaneous preterm birth.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Gargano, Julia Warner Holzman, Claudia Senagore, Patricia Thorsen, Poul Skogstrand, Kristin Hougaard, David M. Rahbar, Mohammad H. Chung, Hwan
Description	Country affiliation: United States Author Affiliation: Gargano JW ( Department of Epidemiology, Michigan State University, B601 West Fee Hall, East Lansing, MI 48824, USA. jgargano@epi.msu.edu)
Abstract	Some spontaneous preterm deliveries (PTD) are caused by occult infections of the fetal membranes (histologic chorioamnionitis [HCA]). High levels of infection-related markers, including some cytokines, sampled from maternal circulation in mid-pregnancy have been linked to PTD, but whether these specifically identify HCA has not been established. We have tested associations between 13 Th1, Th2 and Th17 cytokines and PTD with and without HCA in a prospective cohort study. The study sample included 926 Pregnancy Outcomes and Community Health Study subcohort women; women with medically indicated PTD or incomplete data excluded. A panel of cytokines was assessed using a multiplex assay in maternal plasma collected at 15-27 weeks of gestation. Severe HCA was scored by a placental pathologist blinded to clinical variables. Multivariable polytomous logistic regression was used to estimate adjusted odds ratios (OR) per 1 standard deviation (S.D.) increase in cytokine levels using a 5 level outcome variable: PTD <35 weeks with HCA, PTD <35 weeks without HCA, PTD 35-36 weeks with HCA, PTD 35-36 weeks without HCA, and term (referent). Interleukin (IL)-1beta, IL-2, IL-12, interferon-gamma, IL-4, IL-6 and transforming growth factor-beta were all significantly associated with PTD <35 weeks with HCA, with ORs of 1.6-2.3 per S.D. increase. None of these were associated with PTD <35 weeks without HCA or PTD 35-36 weeks with HCA. Although the tissues of origin of circulating cytokines are unclear, the observed elevations across many cytokines among women who later delivered <35 weeks with HCA may represent a robust immune response to infection within gestational tissues. These results suggest that women with HCA could be identified using relatively non-invasive means.
File Format	HTM / HTML
ISSN	01650378
e-ISSN	18727603
DOI	10.1016/j.jri.2008.08.006
Journal	Journal of Reproductive Immunology
Issue Number	1
Volume Number	79
Language	English
Publisher	Elsevier
Publisher Date	2008-10-01
Publisher Place	Ireland
Access Restriction	Open
Subject Keyword	Discipline Immunology Discipline Reproductive Medicine Chorioamnionitis Immunology Cytokines Blood Obstetric Labor, Premature Etiology Cohort Studies Logistic Models Pregnancy Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't Research Support, U.s. Gov't, P.h.s.
Content Type	Text
Resource Type	Article
Subject	Immunology and Allergy Immunology Reproductive Medicine Obstetrics and Gynecology

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Mid-pregnancy circulating cytokine levels, histologic chorioamnionitis and spontaneous preterm birth

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