Increased tumor necrosis factor-alpha production after lipopolysaccharide stimulation of whole blood in patients with previous preterm delivery complicated by intra-amniotic infection or inflammation

OBJECTIVE: To compare cytokine production after lipopolysaccharide stimulat ion of whole blood from women who were delivered of infants at term compare d with women who were delivered of preterm infants with intra-amniotic evid ence of infection or inflammation. STUDY DESIGN: Whole blood samples from 12 women who were not pregnant and w ho had previously had preterm deliveries before 32 weeks complicated by int ra-amniotic infection or inflammation and samples from 12 age- and race-mat ched control subjects were stimulated with Escherichia coli lipopolysacchar ide. Tumor necrosis factor-alpha and interleukin-6 levels were quantified a t 6 hours and interleukin-10 at 24 hours by enzyme immunoassay. Results wer e compared with use of the Wilcoxon rank sum test. RESULTS: Tumor necrosis factor-alpha production was significantly higher in whole blood from women with histories of a preterm birth and intra-amnioti c infection or inflammation (11,243 +/- 1030 pg/mL [mean +/- SEM]) compared with control subjects (3649 +/- 349 pg/mL) at a lipopolysaccharide concent ration of 1 mug/mL (P = .002). There were no significant differences in int erleukin-6 or interleukin-10 production. CONCLUSION: Women with previous early preterm deliveries who had evidence o f intra-amniotic infection or inflammation had significantly higher tumor n ecrosis factor-alpha production after lipopolysaccharide stimulation of who le blood compared with women with previous term deliveries.