Shree Raj, Simhan Hyagriv N
Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital of the University of Pittsburgh, Pittsburgh, Pennsylvania.
Am J Perinatol. 2015 Jun;32(7):689-94. doi: 10.1055/s-0034-1395478. Epub 2014 Dec 8.
Both history of spontaneous preterm birth (sPTB) and shorter interpregnancy intervals (IPIs) increase the risk of recurrent sPTB. Mechanisms underlying the association between IPI and recurrent sPTB are unknown. We have previously demonstrated that higher concentrations of cervical anti-inflammatory cytokines are a risk factor for sPTB and upper genital tract inflammation. Here, we examine the association between IPI and cervical anti-inflammatory cytokines among women with previous sPTB.
A prospective cohort of 73 women with previous sPTB and cervical interleukins (IL-4, IL-10, and IL-13) measured at < 16 weeks. Using the published principal factor analysis, the anti-inflammatory (ANTI) score was calculated. From our previous work, higher ANTI scores increase the subsequent risk of sPTB. IPI was the time from the previous birth to the conception of current pregnancy. Confounders included education level, marital status, gonorrhea, chlamydia, body mass index, race, and cigarette smoking. IPI and ANTI score were analyzed using univariable and multivariable analyses.
There was a significant negative linear relation between IPI and ANTI score (β = -0.075, p = 0.017). This persisted after adjustment for confounders (p = 0.02). As IPI decreases by 1 month, the ANTI-score-associated risk of sPTB increases approximately by 4%.
Among women with previous sPTB, there was a significant negative linear relation between IPI and ANTI score.
自发性早产（sPTB）病史和较短的妊娠间隔（IPI）都会增加复发性sPTB的风险。IPI与复发性sPTB之间关联的潜在机制尚不清楚。我们之前已经证明，宫颈抗炎细胞因子浓度升高是sPTB和上生殖道炎症的一个危险因素。在此，我们研究有既往sPTB史的女性中IPI与宫颈抗炎细胞因子之间的关联。
对73例有既往sPTB史且在孕16周前测量过宫颈白细胞介素（IL-4、IL-10和IL-13）的女性进行前瞻性队列研究。使用已发表的主成分分析法计算抗炎（ANTI）评分。根据我们之前的研究，较高的ANTI评分会增加后续发生sPTB的风险。IPI是从上一次分娩到本次妊娠受孕的时间。混杂因素包括教育程度、婚姻状况、淋病、衣原体感染、体重指数、种族和吸烟情况。使用单变量和多变量分析对IPI和ANTI评分进行分析。
IPI与ANTI评分之间存在显著的负线性关系（β = -0.075，p = 0.017）。在对混杂因素进行调整后，这种关系仍然存在（p = 0.02）。随着IPI每减少1个月，与ANTI评分相关的sPTB风险大约增加4%。
在有既往sPTB史的女性中，IPI与ANTI评分之间存在显著的负线性关系。
