阴道分泌物中的白细胞介素-8信使核糖核酸：胎膜完整早产情况下先天性感染的产前标志物。

Interleukin-8 mRNA in vaginal secretions: a prenatal marker of congenital infection in case of preterm labor with intact membranes.

作者信息

Kayem G, Maillard F, Batteux F, Weill B, Cabrol D, Goffinet F

机构信息

Department of Obstetrics and Gynaecology, Maternity Port-Royal, Cochin-Saint Vincent-de-Paul Hospital APHP, René Descartes University (Paris V), Paris, France.

出版信息

Prenat Diagn. 2004 Jan;24(1):58-62. doi: 10.1002/pd.795.

DOI:10.1002/pd.795

PMID:14755411

Abstract

OBJECTIVE

To study whether interleukin-8 (IL-8) mRNA in vaginal secretions is associated with congenital infection and preterm delivery in the case of preterm labor with intact membranes.

METHODS

This prospective clinical study in a tertiary referral center included 280 patients who gave birth to 360 infants from 1997 through 1999. IL-8 mRNA in vaginal secretions was determined with reverse transcriptase polymerase chain reaction. Logistic regression was used to examine the association between vaginal IL-8 mRNA and congenital infection independently of the time of birth. Main outcome measures were congenital infection and delivery before 37 and 33 weeks' gestation.

RESULTS

A total of 100 women (100/280 (35.7%)) gave birth before 37 weeks. A total of 54 children (54/360 (15%)) had congenital infection. IL-8 mRNA in vaginal secretions was associated with delivery within 14 days of the sampling (24 (15.6%) vs. 7 (5.6%) p < 0.01), but not with delivery within 48 h, 7 days (p = 0.07) or before 37 or 33 weeks. There were more congenital infections in the group with detectable IL-8 mRNA (37 (19.3%) than in the negative group (17 (10.1%); p < 0.05). IL-8 mRNA was associated with congenital infection independently of the time of birth (OR: 2.6 (1.3-5.1)). This test had a sensitivity for predicting neonatal infection of 69%. Its specificity was 49%, its positive predictive value 19%, and its negative predictive value 90%.

CONCLUSION

IL-8 mRNA could be a prenatal noninvasive vaginal marker of congenital infection.

摘要

目的

研究胎膜完整早产情况下，阴道分泌物中的白细胞介素-8（IL-8）mRNA与先天性感染及早产的相关性。

方法

这项在三级转诊中心开展的前瞻性临床研究纳入了1997年至1999年间分娩360例婴儿的280例患者。采用逆转录聚合酶链反应测定阴道分泌物中的IL-8 mRNA。运用逻辑回归分析阴道IL-8 mRNA与先天性感染之间的关联，且不考虑出生时间。主要观察指标为先天性感染以及妊娠37周和33周前分娩。

结果

共有100名女性（100/280（35.7%））在37周前分娩。共有54名儿童（54/360（15%））患有先天性感染。阴道分泌物中的IL-8 mRNA与采样后14天内分娩相关（24例（15.6%）对7例（5.6%），p<0.01），但与48小时内、7天内分娩（p = 0.07）或37周或33周前分娩无关。IL-8 mRNA可检测组的先天性感染病例数（37例（19.3%））多于阴性组（17例（10.1%）；p<0.05）。IL-8 mRNA与先天性感染相关，且不依赖于出生时间（比值比：2.6（1.3 - 5.1））。该检测对预测新生儿感染的敏感性为69%。其特异性为49%，阳性预测值为19%，阴性预测值为90%。