Simhan Hyagriv N, Krohn Marijane A
Department of Obstetrics and Gynecology, Magee-Womens Hospital, Pittsburgh, PA, USA.
Am J Obstet Gynecol. 2009 Apr;200(4):377.e1-4. doi: 10.1016/j.ajog.2008.10.038. Epub 2009 Feb 6.
Our objective was to explore the relation between the pro- and antiinflammatory cervical cytokine balance in early pregnancy and subsequent early preterm birth.
In this prospective cohort of 218 pregnant women who were enrolled in the first trimester, we assayed cervical concentrations of interleukin-1alpha, -1beta, -6, -4, -10, and -13. Based on these cytokines, we categorized subjects into 1 of 3 strata: high proinflammatory/low antiinflammatory, high antiinflammatory/low proinflammatory, or balanced. The primary outcome of interest was preterm birth at < 34 weeks' gestation.
Women in the high antiinflammatory/low proinflammatory stratum had a subsequent odds ratio for preterm birth < 34 weeks' gestation of 7.7 (95% CI, 4.9-9.1; P = .01), after adjustment for marital status, smoking, bacterial vaginosis, maternal race, and less than high school education.
Women with a relatively hyporesponsive cervical inflammatory milieu in early pregnancy are at higher risk of subsequent early spontaneous preterm birth.
我们的目的是探讨妊娠早期宫颈促炎和抗炎细胞因子平衡与随后的早期早产之间的关系。
在这项对218名孕早期入组的孕妇进行的前瞻性队列研究中，我们检测了宫颈中白细胞介素-1α、-1β、-6、-4、-10和-13的浓度。基于这些细胞因子，我们将受试者分为3个分层中的1个：高促炎/低抗炎、高抗炎/低促炎或平衡。感兴趣的主要结局是妊娠<34周时的早产。
在调整婚姻状况、吸烟、细菌性阴道病、母亲种族和高中以下学历后，高抗炎/低促炎分层的女性妊娠<34周时早产的后续比值比为7.7（95%CI，4.9-9.1；P=.01）。
妊娠早期宫颈炎症环境反应相对低下的女性随后发生早期自然早产的风险更高。
