[Relationship between inflammatory indexes of amniotic fluid and pregnancy outcome of women with cervical incompetence]

Zhonghua Fu Chan Ke Za Zhi. 2018 Aug 25;53(8):517-521. doi: 10.3760/cma.j.issn.0529-567x.2018.08.002.
[Article in Chinese]

Abstract

Objective: To investigate the relationship between the level of amniotic fluid inflammatory factor and the pregnancy outcome in patients with cervical incompetence. Methods: A retrospective case-control study was conducted. Totally 110 cases of pregnant women were diagnosed as cervical incompetence for cervical dilation at the medical examination in Sun Yat-sen Memorial Hospital of Sun Yatsen University, from January 1st, 2015 to December 31th, 2016. A total of 32 patients (29.1%, 32/110) were performed cervical cerclage. According to their neonatal outcomes, they were divided into live infant group (23 cases, 72%) and dead infant group (9 cases, 28%) . The demographic and clinical data of two groups were analyzed and compared. Results: The mean peripheral blood leucocyte counts, the median amniotic tumor necrosis factor-α (TNF-α) and the median interleukin-8 (IL-8) level of two groups were (10.5±2.8) ×10(9)/L vs (13.6±3.1) ×10(9)/L, 23.80 ng/L (14.9-85.5 ng/L) vs 379.00 ng/L (70.2-418.5 ng/L) , and 3 354 ng/L (1 020-7 500 ng/L) vs 7 500 ng/L (4 210-7 500 ng/L) respectively. The differences were statistically significant (all P<0.05) . The amniotic fluid IL-1β, IL-2 receptor, IL-6, IL-10, C-reactive protein and procalcitonin were not significantly different (all P>0.05) between two groups. Conclusions: The peripheral blood leucocyte counts, amniotic fluid TNF-α and IL-8 level are the factors affecting the pregnancy outcome in women with cervical incompetence before cervical cerclage. When IL-8 is higher than 3 580 ng/L and TNF-α is higher than 105 ng/L, the death of perinatal infants could be predicted.

目的: 探讨羊水炎症指标的水平与子宫颈机能不全孕妇妊娠结局的关系。 方法: 收集2015年1月1日至2016年12月31日于中山大学孙逸仙纪念医院因查体发现宫口已扩张而诊断为子宫颈机能不全就诊的孕妇共110例,选择其中接受紧急子宫颈环扎术的孕妇32例(29.1%,32/110),根据其新生儿结局分为活婴组(23例,72%)和死婴组(9例,28%)。分别对两组孕妇子宫颈环扎术前孕妇外周血中性粒细胞百分比及白细胞计数、C反应蛋白(CRP)、羊水微生物及炎症介质的水平[肿瘤坏死因子α(TNF-α),白细胞介素(IL)1β、IL-2、IL-6、IL-8、IL-10]等进行比较分析。 结果: 行子宫颈环扎术的活婴组与死婴组孕妇,子宫颈环扎术前外周血白细胞计数[分别为(10.5±2.8)×10(9)/L、(13.6±3.1)×10(9)/L]、羊水的中位TNF-α水平[分别为23.8 ng/L(14.9~85.5 ng/L)、379.0 ng/L(70.2~418.5 ng/L)]及IL-8水平[分别为3 354 ng/L(1 020~7 500 ng/L)、7 500 ng/L(4 210~7 500 ng/L)]分别比较,差异均有统计学意义(P均<0.05);而其羊水IL-1β、IL-2受体、IL-6、IL-10、CRP、降钙素原的水平、细菌及支原体阳性率分别比较,差异均无统计学意义(P均>0.05)。 结论: 子宫颈机能不全孕妇在子宫颈环扎术前的外周血白细胞计数、TNF-α及IL-8水平是影响其妊娠结局的因素,当IL-8>3 580 ng/L、TNF-α>105 ng/L时,可预测围产儿死亡。.

Keywords: Amniotic fluid; Cerclage, cervical; Cytokines; Pregnancy outcome; Uterine cervical incompetence.

MeSH terms

  • Amniotic Fluid
  • C-Reactive Protein
  • Case-Control Studies
  • Cerclage, Cervical*
  • Female
  • Humans
  • Interleukin-8*
  • Pregnancy
  • Pregnancy Outcome*
  • Pregnancy Trimester, Second / metabolism*
  • Retrospective Studies
  • Tumor Necrosis Factor-alpha
  • Uterine Cervical Incompetence / blood*
  • Uterine Cervical Incompetence / surgery

Substances

  • CXCL8 protein, human
  • Interleukin-8
  • Tumor Necrosis Factor-alpha
  • C-Reactive Protein