Objectives: Evaluation of change of cervicovaginal fluid (CVF) cytokines’ levels
during pregnancy and its relation to incidence of preterm birth (PTB).
Patients & Methods: Pregnant women with history of PTB and cervical
length < 25 mm (Study group) and 42 normal pregnant women (Control
group) gave CVF sample (Sample-I) at start of second trimester. Study women
undertook McDonald cervical cerclage (CC) and Sample-II of CVF was
obtained at time of labor or removal of cerclage stitch. ELISA estimation of
CVF tumor necrosis factor-α (TNF-α) and interleukins (IL)-6 and -10 levels.
Study outcomes included differences in cytokines’ levels between samples and
groups. Results: Sample-I cytokines’ levels were significantly higher in study
than control women. Cytokines’ levels in Sample-II were significantly higher
in control, while were significantly lower in study women compared to Sample-
I. Sixteen study women had PTB and had significantly higher CVF levels
of IL-10 and TNF-α estimated in both samples than women had no PTB. Pregnancy
duration was negatively correlated with maternal body mass index
(BMI) and cytokines’ levels, while was positively correlated with inter-pregnancy
interval (IPI). Cytokines’ levels were positively correlated with BMI and negatively
correlated with IPI. Short IPI and high TNF-α levels are negative predictors
for pregnancy duration. Conclusion: High BMI, short IPI and high
CVF inflammatory cytokines’ levels negatively affect pregnancy duration especially
in women with history of recurrent PTB. Early prophylactic CC for
women at high-risk of SPTB can modulate local immune disturbance, reduce
incidence of SPTB and prolong pregnancy duration.