Simhan Hyagriv N, Caritis Steve N, Krohn Marijane A, Martinez de Tejada Begoña, Landers Daniel V, Hillier Sharon L
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Research Institute, Pittsburgh, PA 15213, USA.
Am J Obstet Gynecol. 2003 Aug;189(2):560-7. doi: 10.1067/s0002-9378(03)00518-0.
The purpose of this study was to test the hypothesis that suppressed immune function in the lower genital tract, as represented by decreased concentrations of cervical proinflammatory cytokines early in pregnancy, is a risk factor for clinical chorioamnionitis.
Interleukin-1beta, interleukin-6, and interleukin-8 were measured by enzyme-linked immunosorbent assay in cervical fluid from a cohort of 403 women at 8 to 20 weeks of gestation.
Of the 88 women with one low cytokine concentration, 8.0% of the women had clinical chorioamnionitis compared with 4.4% among the 228 women with no low cytokines (adjusted odds ratio, 2.0; 95% CI, 0.7-5.8). Clinical chorioamnionitis occurred in 15 of the 87 women (17.2%), with two or three depressed cytokine concentrations compared with women with no low cytokines (adjusted odds ratio, 5.1; 95% CI, 2.0-13.0).
Genital tract immune hyporesponsiveness, as represented by low cervical concentrations of multiple cytokines, permits subsequent clinical chorioamnionitis.
本研究旨在验证以下假设，即妊娠早期宫颈促炎细胞因子浓度降低所代表的下生殖道免疫功能抑制是临床绒毛膜羊膜炎的危险因素。
采用酶联免疫吸附测定法，对403名妊娠8至20周妇女的宫颈液中的白细胞介素-1β、白细胞介素-6和白细胞介素-8进行检测。
在88名细胞因子浓度低的妇女中，8.0%的妇女患有临床绒毛膜羊膜炎，而在228名细胞因子浓度无降低的妇女中，这一比例为4.4%（校正比值比为2.0；95%可信区间为0.7 - 5.8）。在87名细胞因子浓度有两到三项降低的妇女中，17.2%发生了临床绒毛膜羊膜炎，相比细胞因子浓度无降低的妇女（校正比值比为5.1；95%可信区间为2.0 - 13.0）。
以宫颈多种细胞因子浓度低为代表的生殖道免疫反应低下会引发后续的临床绒毛膜羊膜炎。
