Amer J Perinatol
DOI: 10.1055/s-0037-1608631
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Impact of Pregnancy History and 17-Hydroxyprogesterone Caproate on Cervical Cytokines and Matrix Metalloproteinases

Steve N. Caritis1, Gary Hankins2, Mary Hebert3, 4, David M. Haas5, Mahmoud Ahmed2, Hyagriv Simhan1, Laura A. Haneline6, John Harris1, Justine Chang4, Alyssa Stephenson Famy4, Patrick Yorio1, Zhaoxia Ren7, Mary E. D'Alton8, Raman Venkataramanan9, 10
  • 1Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 2Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
  • 3Department of Pharmacy, University of Washington, Seattle, Washington
  • 4Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington
  • 5Department of Obstetrics and Gynecology, Indiana University, Indianapolis, Indiana
  • 6Department of Pediatrics, Indiana University, Indianapolis, Indiana
  • 7Obstetric and Pediatric Pharmacology and Therapeutics Branch, Eunice Shriver National Institute of Child Health and Human Development, National Institutes of Health, Washington
  • 8Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York
  • 9Department of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 10Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania
Further Information

Publication History

27 July 2017

30 September 2017

Publication Date:
15 November 2017 (eFirst)

Abstract

Objective The objective of this study was to evaluate the impact of pregnancy history and 17-hydroxyprogesterone caproate (17-OHPC) treatment on cervical fluid cytokines and matrix metalloproteinases (MMPs).

Study Design Cervical fluid was obtained between 160/7 and 246/7 weeks from women with only prior term births (controls, n = 26), women with one or more prior spontaneous preterm births (SPTBs) choosing to receive 17-OHPC (17-OHPC, n = 24), or to not receive 17-OHPC (refusers, n = 12). Cervical fluid collections were repeated 2, 4, and 8 weeks after the first sample and concentrations of MMPs and cytokines were measured by multiplex immune assay.

Results Among women whose earliest prior delivery occurred between 16 and 23 weeks, cervical fluid concentration of interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-α at baseline were significantly elevated when compared with cervical cytokines of women whose earliest delivery occurred between 32 and 36 weeks (relative risk ratio was 3.37 for IL-6 [95% confidence interval, CI, 1.08–10.53, p < 0.05], 2.81 for IL-10 [95% CI, 1.39–5.70, p < 0.05], and 6.34 for TNF-α [95% CI, 2.19–18.68, p < 0.001]). Treatment with 17-OHPC had no significant impact on these cytokines.

Conclusion The cervical fluid of women with a history of an early prior SPTB is characterized by inflammation that is unaffected by 17-OHPC.

Funding

Funding for grant HD 047905, HD 047892, HD 047891, and HD 063094 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and UL1TR000423 from the National Center for Advancing Translational Sciences of the National Institutes of Health.