Mid-trimester cervical inflammatory milieu and sonographic cervical length.

Abstract

The purpose of this study was to explore the relation between the relative balance of pro- and antiinflammatory cytokines in cervical fluid and mid-trimester cervical length. In this prospective longitudinal cohort of women with a previous spontaneous preterm birth, mid-trimester cervical length ultrasound scans and cervical fluid levels were obtained serially. Multiple pro- and antiinflammatory cytokines were selected. We summed the multiples of the median for proinflammatory cytokines to generate the proinflammatory and the antiinflammatory scores. The relation between cervical length and pro-/antiinflammatory ratio was assessed by generalized estimating equations. The pro-/antiinflammatory ratio had a negative linear association with cervical length (beta = -0.09; P < .001). Sixty percent of visits demonstrated greater concentrations of proinflammatory cytokines relative to antiinflammatory cytokines. This relationship did not change between first and last visits. Among women with a previous preterm birth, shorter mid-trimester cervical length is associated with a more proinflammatory balance of cytokines in the cervical inflammatory milieu.