Objective: The aim of the study was to assess the relationship of maternal serum IL-6 and TNF-alfa levels with fertility and parity of women with pregnancies complicated by premature rupture of membranes (PROM).
Materials and methods: The maternal serum of IL-6 and TNF-alfa levels were evaluated in patients with PROM between 24-34 weeks of pregnancy (the study group, n = 45). The control group consisted of healthy pregnancy (n = 41) at 24-34 weeks of gestation. Serum cytokines concentrations were measured by commercial available enzyme-linked immunosorbent assays. C-reactive protein level and WBC were estimated in both groups.
Results: The positive correlation between maternal serum TNF-alfa and fertility (R = 0.322, p = 0.042), and parity (R = 0.339, p = 0.032) in patients in the study group was found. No relationship of evaluated cytokines, CRP, WBC with fertility and parity was found in healthy pregnancy women. Compared to primigravidas, multiparas with PROM had significantly higher serum levels of TNF-alfa (1571.41 pg/ml vs 854.54 pg/ml, p = 0.014); serum IL-6 levels was significantly higher in patients with fourth delivery or more compared to patients with third delivery and less (32.32 pg/ml vs 5.52, p = 0.039). CRP concentration and WBC were comparable in those groups.
Conclusion: 1. Women with at least one pregnancy in the past are at higher risk of premature rupture of membranes in following pregnancies. 2. Every suspicion of intrauterine infection or presence of potential risk factors such as bacterial vaginosis, cervicitis, kolpitis or urinary tract infection should be carefully evaluated in this group of patients.