Cervical length and gestational age at admission as predictors of intra‐amniotic inflammation in preterm labor with intact membranes
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Discussion
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Implication
Cohort study reveals cervical length and gestational age predict intra-amniotic inflammation in preterm labor, suggesting an effective noninvasive screening strategy.
Key Points
- To determine whether cervical length and gestational age at admission can non-invasively predict intra-amniotic inflammation in women presenting with preterm labor and intact membranes.
- Assessed 93 pregnant women admitted with preterm labor and intact membranes who underwent admission transvaginal sonography to measure cervical length.
- Performed transabdominal amniocentesis within 48 hours to assess microbial cultures and measure amniotic fluid interleukin-6 (IL-6) levels.
- Used ROC curve analysis to establish IL-6 diagnostic cut-offs and logistic regression to identify independent predictors of intra-amniotic inflammation.
- Intra-amniotic infection occurred in 14% of patients and inflammation in 28%, with an optimal IL-6 threshold of 13.4 ng/mL identified for infection.
- Cervical length < 15 mm and gestational age at admission < 28 weeks were independently associated with intra-amniotic inflammation and worse perinatal outcomes.
- A screening rule combining admission < 28 weeks or admission between 28 and 32 weeks with cervical length < 15 mm detected 84.0% of inflammation cases with a positive predictive value of 48.8%.
Cite This Study
Palacio et al. (2009) studied this question.