Steve N Caritis1, Gary Hankins2, Mary Hebert3,4, David M Haas5, Mahmoud Ahmed2, Hyagriv Simhan1, Laura A Haneline6, John Harris1, Justine Chang4, Alyssa Stephenson Famy4, Patrick Yorio1, Zhaoxia Ren7, Mary E D'Alton8, Raman Venkataramanan9,10. 1. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania. 2. Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas. 3. Department of Pharmacy, University of Washington, Seattle, Washington. 4. Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington. 5. Department of Obstetrics and Gynecology, Indiana University, Indianapolis, Indiana. 6. Department of Pediatrics, Indiana University, Indianapolis, Indiana. 7. Obstetric and Pediatric Pharmacology and Therapeutics Branch, Eunice Shriver National Institute of Child Health and Human Development, National Institutes of Health, Washington. 8. Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York. 9. Department of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania. 10. Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania.
Abstract
OBJECTIVE: The objective of this study was to evaluate the impact of pregnancy history and 17-hydroxyprogesterone caproate (17-OHPC) treatment on cervical fluid cytokines and matrix metalloproteinases (MMPs). STUDY DESIGN: Cervical fluid was obtained between 160/7 and 246/7 weeks from women with only prior term births (controls, n = 26), women with one or more prior spontaneous preterm births (SPTBs) choosing to receive 17-OHPC (17-OHPC, n = 24), or to not receive 17-OHPC (refusers, n = 12). Cervical fluid collections were repeated 2, 4, and 8 weeks after the first sample and concentrations of MMPs and cytokines were measured by multiplex immune assay. RESULTS: Among women whose earliest prior delivery occurred between 16 and 23 weeks, cervical fluid concentration of interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-α at baseline were significantly elevated when compared with cervical cytokines of women whose earliest delivery occurred between 32 and 36 weeks (relative risk ratio was 3.37 for IL-6 [95% confidence interval, CI, 1.08-10.53, p < 0.05], 2.81 for IL-10 [95% CI, 1.39-5.70, p < 0.05], and 6.34 for TNF-α [95% CI, 2.19-18.68, p < 0.001]). Treatment with 17-OHPC had no significant impact on these cytokines. CONCLUSION: The cervical fluid of women with a history of an early prior SPTB is characterized by inflammation that is unaffected by 17-OHPC. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: The objective of this study was to evaluate the impact of pregnancy history and 17-hydroxyprogesterone caproate (17-OHPC) treatment on cervical fluid cytokines and matrix metalloproteinases (MMPs). STUDY DESIGN: Cervical fluid was obtained between 160/7 and 246/7 weeks from women with only prior term births (controls, n = 26), women with one or more prior spontaneous preterm births (SPTBs) choosing to receive 17-OHPC (17-OHPC, n = 24), or to not receive 17-OHPC (refusers, n = 12). Cervical fluid collections were repeated 2, 4, and 8 weeks after the first sample and concentrations of MMPs and cytokines were measured by multiplex immune assay. RESULTS: Among women whose earliest prior delivery occurred between 16 and 23 weeks, cervical fluid concentration of interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-α at baseline were significantly elevated when compared with cervical cytokines of women whose earliest delivery occurred between 32 and 36 weeks (relative risk ratio was 3.37 for IL-6 [95% confidence interval, CI, 1.08-10.53, p < 0.05], 2.81 for IL-10 [95% CI, 1.39-5.70, p < 0.05], and 6.34 for TNF-α [95% CI, 2.19-18.68, p < 0.001]). Treatment with 17-OHPC had no significant impact on these cytokines. CONCLUSION: The cervical fluid of women with a history of an early prior SPTB is characterized by inflammation that is unaffected by 17-OHPC. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Catherine Y Spong; Paul J Meis; Elizabeth A Thom; Baha Sibai; Mitchell P Dombrowski; Atef H Moawad; John C Hauth; Jay D Iams; Michael W Varner; Steve N Caritis; Mary J O'Sullivan; Menachem Miodovnik; Kenneth J Leveno; Deborah Conway; Ronald J Wapner; Marshall Carpenter; Brian Mercer; Susan M Ramin; John M Thorp; Alan M Peaceman; Steven Gabbe Journal: Am J Obstet Gynecol Date: 2005-09 Impact factor: 8.661