Amniotic fluid interleukin-6 and preterm delivery: a review.

Abstract

OBJECTIVE:

To evaluate the potential role of amniotic fluid (AF) interleukin (IL)-6 as a predictor of preterm delivery and to consider possible explanations for the proportion of women with elevated AF IL-6 who deliver preterm yet lack microbiologically detectable intra-amniotic infection.

DATA SOURCES:

We searched the English language human literature in MEDLINE, 1966 through September 1999, using the keywords "labor/infant," "premature," "cytokines/interleukin-6," and "AF." We also examined abstracts from the 1999 meetings of the Society for Maternal-Fetal Medicine and the Society for Epidemiologic Research. We identified other studies by reviewing the reference lists of published articles.

METHODS OF STUDY SELECTION:

The MEDLINE search yielded 55 citations. We focused on studies that reported on the association between AF IL-6 and preterm delivery.

TABULATION, INTEGRATION, AND RESULTS:

There is consensus in the literature that elevated AF IL-6 is a stronger predictor of preterm delivery than intra-amniotic infection detected by either microbiologic culture or polymerase chain reaction (PCR). Among women with elevated AF IL-6, PCR could detect a higher proportion of intra-amniotic infection than culture. A number of women with elevated AF IL-6 (33-70%) deliver preterm and do not have evidence of intra-amniotic infection by either culture or PCR. Possible explanations for this observation are considered.

CONCLUSION:

Elevated AF IL-6 is strongly associated with preterm delivery and merits future consideration in clinical settings to predict preterm delivery and guide patient care. Development of improved polymerase chain reaction-based clinical methods to detect intra-amniotic infection is necessary to better understand the relationship between elevated AF IL-6, intra-amniotic infection, and preterm delivery.

• Authors: A Y El-Bastawissi, M A Williams, D E Riley, J Hitti, J N Krieger
• Journal: Obstetrics and gynecology (Obstet Gynecol) Vol. 95 Issue 6 Pt 2 Pg. 1056-64 (Jun 2000) ISSN: 0029-7844 [Print] United States
• PMID: 10808034 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S., Review)

Chemical References

• Cytokines
• Interleukin-6
• C-Reactive Protein

Topics

• Amniotic Fluid (chemistry)
• C-Reactive Protein (analysis)
• Cytokines (analysis)
• Female
• Humans
• Interleukin-6 (analysis)
• Obstetric Labor, Premature (physiopathology)
• Polymerase Chain Reaction
• Predictive Value of Tests
• Pregnancy
• Sensitivity and Specificity