Granulocyte colony-stimulating factor in preterm and term pregnancy, parturition, and intra-amniotic infection

Objective: To determine the sources of granulocyte colony-stimulating facto r (G-CSF) in amniotic fluid and to examine its relation to labor and clinic ally diagnosed intra-amniotic infection. Methods: We assessed G-CSF and C-CSF receptor expression in placentas (n = 50) from 5-40 weeks' gestation, and G-CSF concentrations were measured in a mniotic fluid (n = 146), bronchoalveolar lavage fluid (n = 8), and paired m aternal serum, cord blood, neonatal serum, and neonatal urine samples (n = 16). Results: Immunohistochemical staining and messenger RNA analysis showed pla cental expression of G-CSF and G-CSF receptor throughout gestation. The num ber of decidual stromal cells expressing G-CSF receptor was significantly h igher in women with intra-amniotic infection compared with women without in fection (27 +/- 2 versus 18 +/- 3 cells per high power field, P = .02). Amn iotic fluid concentrations of G-CSF were not significantly different in non infected preterm compared with term samples (1708 +/- 1673 versus 1612 +/- 2100 pg/mL, P = .9). Labor was not associated with a significant increase i n amniotic fluid G-CSF concentrations (1864 +/- 3151 versus 1612 +/- 2100 p g/mL, P = .77, term labor versus no labor; 3335 +/- 5364 versus 1708 +/- 16 73 pg/mL, P = .09, preterm). Concentrations of G-CSF in maternal serum, amn iotic fluid, bronchoalveolar lavage fluid, and neonatal urine were increase d during intraamniotic infection (all P < .05). Conclusion: Amniotic fluid G-CSF concentrations were similar in preterm and term pregnancies and were not significantly influenced by labor. Intra-amn iotic infection was associated with an increased number of placental cells expressing the G-CSF receptor and higher concentrations of C-CSF in amnioti c fluid, maternal serum, neonatal urine, and neonatal bronchoalveolar lavag e samples. (Obstet Gynecol 2001;97:229-34. (C) 2001 by The American College of Obstetricians and Gynecologists.).