조기 진통 및 조기 양막 파수 임신부의 자궁경부 분비물 내 Interleukin-6의 임상적 의의

Abstract

Background：This study is conducted to determine the clinical efficacy of measurement of IL-6 concentration in cervical discharge as a biochemical predictor of preterm labor and PROM. Materials and Methods：Twenty-two pregnant women with preterm labor and 28 women with preterm rupture of membrane(PROM) between 20-36 gestational weeks were selected as study group, and 26 normal pregnant women were selected as control group. In both groups, following routine antenatal laboratory tests, concentration of interleukin-6(IL-6) in cervical discharge and amniotic fluid(in case of preterm labor and PROM) were estimated, and maternal C-reactive protein(CRP) level and WBC count were checked also. To compare the microbiological environment of both groups, Gram stain and culture of cervical smear were undertaken. Results ：There were no significant differences in maternal age, gravity, parity, gestational age at sampling, and prior preterm delivery, but there were significant differences in initial cervical dilation, effacement, cervicovaginal pH, and preterm delivery in each groups. The average IL-6 level of cervical discharge in women with preterm labor and PROM were significantly higher than control group (p＜0.01). The distribution of women with preterm labor and PROM were significantly different from control group, when 186.7 pg/mL was selected as cutoff value(p＜0.01). There was strong positive correlation between IL-6 concentration in cervical discharge and amniotic fluid IL-6 concentration (r=0.865, p＜0.05). There was no significant difference in CRP in each groups. Maternal WBC count of PROM group at admission was higher than that of preterm labor and control group, but was not statistically significant (p=0.062). Gram (-) rods was detected frequently in women with preterm labor and PROM than control group (p＜0.05). The distribution of microorganisms in cervical discharge in women with preterm labor and PROM were different from control group. Conlusion：The results of this study suggested that cervical IL-6 concentration could be used as an indicator detecting the high risk pregnant women who might develop preterm labor and PROM, and could be accepted as a noninvasive diagnostic marker of intrauterine infection