- Interluekin 6 and integrated index of anamnesis, initial health status and gestation course as predictors of preterm delivery in women with multiple gestation
Interluekin 6 and integrated index of anamnesis, initial health status and gestation course as predictors of preterm delivery in women with multiple gestation
PERINATOLOGY AND PEDIATRIC. UKRAINE. 2018.1(73):41-47; doi 10.15574/PP.2018.73.41
Bulavenko O. V., Vozniuk А. V., Tytarenko N. V., Kukuruza I. L.
National Pirogov Memorial Medical University, Vinnytsia, Ukraine
Objective — to identify diagnostic value of interleukin 6 and an integrated index of the anamnesis, initial health status and gestation course as predictors of preterm delivery in women with multiple gestation.
Material and methods. The analysis of anamnesis, initial health status, course of gestation and other characteristics of 78 women with multiple gestation was performed. Out of those women, in 25 pregnants there was preterm delivery before 34 weeks of gestation and in 53 cases — after 34 weeks. To predict the preterm delivery, a modified predicting model of the preterm delivery risk in women with multiple gestation as well as the interleukin 6 level in cervical mucus were used.
Results. Using ROC-analysis the threshold values were calculated, which were as follows: for the proposed integrated index of the anamnesis, initial health status and gestation course, it made up >-2.14 points (sensitivity — 64%, specificity — 81.1%), and the threshold value for cervical interleukin 6 was >41.65 pg/mL (sensitivity — 84%, specificity — 71.1%).
Conclusions. The comprehensive evaluation of the proposed integrated index of anamnesis, initial health status, gestation course and interleukin 6 concentration in cervical mucus allows predicting with high sensitivity and specificity preterm delivery in women with multiple gestation. The overall determination of the index with >-2.14 points and interleukin 6 concentration in cervical mucus of >41.65 pg/mL predicts preterm delivery in women with multiple gestation with negative predictive value of 90.4% and sensitivity of 80%.
Key words: multiple gestation, preterm delivery, interleukin 6, model of logistic regression.
1. Bulavenko OV, Vozniuk AV. (2017). Predicting the risk of preterm birth in women with multiple pregnancies in the population cohort of Vinnitsa region depending on their init ial stat e of health and the course of pregnancy. Biomedical and Вiosocial Аnthropology. 28: 123-127.
2. Savelyeva GM, Shalina RI, Kurcer MA, Klimenko PA, Sichinаva LG, Panina OB, Plekhanova EP, Vykhristyuk YuV, Lebedev EV. (2012). Preterm birth as the most important problem of modern obstetrics. Obstetrics and gynecology. 2: 4-10.
3. Agarwal P, Sriram B, Lim SB, Tin AS, Tin AS, Rajadurai VS. (2013). Borderline viability — neonatal outcomes of infants in Singapore over a period of 18 years (1990—2007). Ann. Acad. Med. Singapore. 42 (7): 328—337. PMid:23949262
4. Bastek JA, Sammel MD, Srinivas SK, McShea MA, Foreman MN, Elovitz MA, Metlay JP. (2012). Clinical prediction rules for preterm birth in patients presenting with preterm labor. Obstet. Gynecol. 119 (6): 1119—1128. https://doi.org/10.1097/AOG.0b013e31825503e5; PMid:22617575
5. Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller AB, Narwal R. (2012). National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 379: 2162—2167. https://doi.org/10.1016/S0140-6736(12)60820-4
6. Chaemsaithong P, Romero R, Docheva N, Chaiyasit N, Bhatti G, Pacora P, Hassan SS, Yeo L, Erez O. (2018). Comparison of rapid MMP-8 and interleukin-6 point-of-care tests to identify intra-amniotic inflammation/infection and impending preterm delivery in patients with preterm labor and intact membranes. J Matern Fetal Neonatal Med. 31 (2): 228—244. https://doi.org/10.1080/14767058.2017.1281904; PMid:28081646
7. Dolgun ZN, Inan C, Altintas AS, Okten SB, Sayin NC. (2016). Preterm birth in twin pregnancies: Clinical outcomes and predictive parameters. Pak. J. Med Sci. 32 (4): 922—996. PMid:27648040 PMCid:PMC5017103
8. Hadzi Lega M, Daneva Markova A, Stefanovic M, Tanturovski M. (2015). Interleukin 6 and fetal fibronectin as a predictors of preterm delivery in symptomatic patients. Bosn J Basic Med Sci. 15(1): 51—56. https://doi.org/10.17305/bjbms.2015.1.93; PMid:25725144 PMCid:PMC4365677
9. Kazemier BM, Buijs PE, Mignini L, Limpens J, de Groot CJ, Mol BW; EBM CONNECT. (2014). Impact of obstetric history on the risk of spontaneous preterm birth in singleton and multiple pregnancies: a systematic review. BJOG. 121 (10): 1197—1208. https://doi.org/10.1111/1471-0528.12896; PMid:24899245
10. Liu Y, Liu Y, Zhang R, Zhu L, Feng Z. (2017). Early- or mid-trimester amniocentesis biomarkers for predicting preterm delivery: a meta-analysis. Ann Med. 49 (1): 1—10. https://doi.org/10.1080/07853890.2016.1211789; PMid:27494609
11. Mailath-Pokorny M, Polterauer S, Kohl M, Kueronyai V, Worda K, Heinze G, Langer M. (2015). Individualized assessment of preterm birth risk using two modified prediction models. Eur J Obstet Gynecol Reprod Biol. 185: 42—48. https://doi.org/10.1016/j.ejogrb.2014.12.010; PMid:25616254
12. Musilova I, Andrys C, Drahosova M, Soucek O, Pliskova L, Jacobsson B, Kacerovsky M. (2018). Cervical fluid interleukin 6 and intra-amniotic complications of preterm prelabor rupture of membranes. J Matern Fetal Neonatal Med. 31 (7): 827—836. https://doi.org/10.1080/14767058.2017.1297792; PMid:28277919
13. Oz M, Polat B, Ozgu E, Seckin KD, Tasin C, Danisman N. (2015). Interleukin-6 and C-reactive protein levels in the amniotic fluid as indicators of preterm delivery in Turkish women. Clin Exp Obstet Gynecol. 42 (6): 801—804. PMid:26753490
14. Pakrashi T, Defranco EA. (2013). The relative proportion of preterm births complicated by premature rupture of membranes in multifetal gestations: a population-based study. Am J Perinatol. 30 (1): 69—74. PMid:22773281
15. Vogel JP, Torloni MR, Seuc A, Betran AP, Widmer M, Souza JP, Merialdi M. (2013). Maternal and Perinatal Outcomes of Twin Pregnancy in 23 Low- and Middle-Income Countries. PLoS One. 8 (8): e70549. https://doi.org/10.1371/journal.pone.0070549; PMid:23936446 PMCid:PMC3731264