INTERLEUKIN-1-ALPHA, INTERLEUKIN-6 AND INTERLEUKIN-8 IN CERVICO VAGINAL SECRETION FOR SCREENING OF PRETERM BIRTH IN TWIN GESTATION/

Background. The purpose was to determine the prognostic value of inter leukin (IL) 1-alpha, IL-6 and IL-8 in cervico/vaginal secretion for pr eterm birth (<37 weeks of gestation) in twin pregnancies. Methods. The study included screening of 121 women.with twin pregnancies with samp ling at 24, 26, 28, 30, 32 and 34 weeks of gestation. IL-1 alpha, IL-6 and IL-8 was analyzed with ELISA immunoassays. The detection limit wa s 30 pg/ mL for IL-1 and IL-8 and 40 pg/mL for IL-6. Vaginal fluid was smeared and dried for later evaluation of bacterial vaginosis (presen ce of clue cells). Results. Spontaneous preterm birth occurred in 36 w omen and 65 women were delivered at term. IL-8 was significantly highe r (p=0.03) in samples from women delivered preterm (median 3.72 ng/g m ucus, range <0.07-220.00) compared with samples from women delivered a t term (median 3.03 ng/g mucus, range<0.08-378.60). At 28 weeks of ges tation, IL-8 (cut off 1.75 ng/g mucus) was associated with preterm del ivery (relative risk 2.2, CI 95% 1.1-4.5) with a sensitivity, specific ity, positive and negative predictive value of 78.8, 45.8, 44.8 and 79 .4%, respectively. The levels of IL-1 alpha and IL-6 were not signific antly associated with preterm birth. Bacterial vaginosis was found in 47/541 (8.7%) samples analyzed. The levels of IL-1 alpha and IL-8 were significantly higher in samples positive for bacterial vaginosis than in negative samples (p<0.0001 and p<0.01, respectively). There was no significant association between the level of IL-6 and bacterial vagin osis. Conclusions. IL-8, but not IL-1 alpha and IL-6, was associated w ith preterm delivery but the relationship was too weak to be of predic tive value for preterm birth in twin pregnancies. IL-1 alpha and IL-8, but not IL-6, were associated with bacterial vaginosis.