Venkatesh Kartik K, Cantonwine David E, Ferguson Kelly, Arjona Melanie, Meeker John D, McElrath Thomas F
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, USA.
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, USA.
Am J Reprod Immunol. 2016 Nov;76(5):376-382. doi: 10.1111/aji.12545. Epub 2016 Aug 1.
We assess whether inflammatory and oxidative stress markers early in pregnancy are associated with decreasing cervical length in the second trimester.
This is a secondary analysis of a nested case-control study of preterm birth conducted at a tertiary care center from 2006 to 2008. Plasma inflammatory markers included the following: interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-1 beta (IL-1β), tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP); and urine oxidative stress markers included the following: 8-hydroxydeoxyguanosine (8-OHdG) and 8-isoprostane, measured at two study visits (median 10 and 18 weeks of gestation). The primary outcome was cervical length<10th percentile measured between 16 and 24 weeks of gestation. Logistic regression models were used, adjusting for body mass index, age, race, parity, tobacco use, education, and gestational age at cervical length measurement.
Among 384 observed women, the 10th percentile cervical length was 3.0 cm. IL-10 levels were significantly higher among women with a cervical length<10th percentile compared to women with a longer cervix (mean IL-10: 95.5 vs 25.8 pg/mL, P<.01). Similarly, IL-6 levels were significantly higher among women with a cervical length<10th percentile (mean IL-6: 25.2 vs 4.3 pg/mL, P<.01). After controlling for potential confounders, an increase in IL-10 was significantly associated with a cervical length<10th percentile at both 10 and 18 weeks (adjusted odd ratio [AOR]: 1.74; 95% CI: 1.18-2.58; P=.005). At 18 weeks, only IL-6 was also significantly associated with a cervical length<10th percentile (AOR: 1.54; 95% CI: 1.11-2.13; P=.009). Other inflammatory biomarkers, including CRP, IL-1β, TNF-α, and oxidative stress biomarkers, 8-OHdG and 8-isoprostane, were not associated with cervical length.
There was a significant association between the cytokines IL-6 and IL-10 early in pregnancy and decreased cervical length, suggesting an imbalance of immune regulation could impact cervical length.
我们评估妊娠早期的炎症和氧化应激标志物是否与孕中期宫颈长度缩短有关。
这是对2006年至2008年在一家三级医疗中心进行的早产巢式病例对照研究的二次分析。血浆炎症标志物包括以下几种：白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）和C反应蛋白（CRP）；尿液氧化应激标志物包括以下几种：8-羟基脱氧鸟苷（8-OHdG）和8-异前列腺素，在两次研究访视时（妊娠中位数10周和18周）进行测量。主要结局是妊娠16至24周期间测量的宫颈长度<第10百分位数。使用逻辑回归模型，并对体重指数、年龄、种族、产次、吸烟情况、教育程度以及测量宫颈长度时的孕周进行了校正。
在384名观察对象中，宫颈长度的第10百分位数为3.0厘米。宫颈长度<第10百分位数的女性的IL-10水平显著高于宫颈较长的女性（平均IL-10：95.5 vs 25.8 pg/mL，P<.01）。同样，宫颈长度<第10百分位数的女性的IL-6水平也显著更高（平均IL-6：25.2 vs 4.3 pg/mL，P<.01）。在控制了潜在混杂因素后，IL-10的升高在妊娠10周和18周时均与宫颈长度<第10百分位数显著相关（校正比值比[AOR]：1.74；95%置信区间：1.18 - 2.58；P=.005）。在妊娠18周时，只有IL-6也与宫颈长度<第10百分位数显著相关（AOR：1.54；95%置信区间：1.11 - 2.13；P=.009）。其他炎症生物标志物，包括CRP、IL-1β、TNF-α以及氧化应激生物标志物8-OHdG和8-异前列腺素，与宫颈长度无关。
妊娠早期细胞因子IL-6和IL-10与宫颈长度缩短之间存在显著关联，提示免疫调节失衡可能影响宫颈长度。
