MATERNAL SERUM GRANULOCYTE-COLONY-STIMULATING FACTOR IN PRETERM BIRTHWITH SUBCLINICAL CHORIOAMNIONITIS

Preterm birth has been linked with intrauterine infection and inflamma tion. Serum and amniotic fluid markers of inflammation, such as interl eukin-1 (IL-1), IL-6, and granulocyte-colony stimulating factor (G-CSF ), have been associated with clinical chorioamnionitis and preterm del ivery. As G-CSF regulates the production and maturation of neutrophils , we sought to determine if maternal serum G-CSF levels are elevated i n patients with preterm birth with subclinical histologic chorioamnion itis. Maternal serum G-CSF levels were significantly different among f ive groups of women studied (P < .001, Kruskall-Wallis test), and were highest in subjects with preterm labor who delivered preterm (P < .05 , Mann-Whitney U test). Among women with preterm labor who delivered p reterm, maternal serum G-CSF levels were significantly higher if histo logic chorioamnionitis was present than when histologic evidence of in fection was not present (P = 0.04, Mann-Whitney U test). Intrauterine infection may cause a local inflammatory process and initiate preterm labor. This inflammatory response may include production of G-CSF, whi ch would enter the circulation and stimulate the migration of neutroph ils to the site of infection. Our data support this concept, as matern al serum G-CSF is elevated with subclinical infection in association w ith preterm birth. (C) 1997 Elsevier Science Ireland Ltd.