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Journal of the Society for Gynecologic Investigation
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Amniotic Fluid Interleukin-6 and Interleukin-8 Levels Predict the Success of Tocolysis in Patients With Preterm Labor

John R. Allbert

Robert W. Naef

Kenneth G. Perry

Everett F. Magann

Neil S. Whitworth

John C. Morrison

OBJECTIVE: To determine whether the levels of the cytokines interleukin-6 (IL-6) and IL-8 in amniotic fluid identify patients with preterm labor who are resistant to tocolysis.

METHODS: Amniocenteses were performed in 23 women with documented preterm labor at 20-32 weeks'gestational age who were treated subsequently with tocolytics. The concentrations of IL-6 and IL-8 in amniotic fluid were determined by double-antibody radioimmunoassay methods using recombinant human IL standards.

RESULTS: Of the 23 patients, five failed to respond to tocolysis (four delivered within 48 hours), and of the remaining 18, all delivered more than 9 days after tocolysis was initiated (mean 31 ± 10 days; range 9-61). In women who had failed tocolysis, discriminatory concentrations of IL-6 and IL-8 were 20 and 15 ng/mL, respectively. Of the patients who had amniotic fluid concentrations higher than these thresholds, all failed tocolysis (100% positive predictive value) and delivered within 6 days. The patients with levels below these discriminatory concentrations had successful tocolysis, and 17 of 18 delivered more than 2 weeks after treatment (95% negative predictive value).

CONCLUSION: The success of tocolysis and thus delivery remote from an episode of preterm labor is associated with discriminatory amniotic fluid IL-6 and IL-8 levels of less than 20 and less than 15 ng/mL, respectively. If the immunologic response that causes the release of IL-6 and IL-8 has not occurred, the likelihood of successful tocolysis is extremely high. However, if both IL-6 and IL-8 are elevated, tocolysis is likely to fail and delivery may occur within 48 hours. (J Soc Gynecol Invest 1994;1:264-8)

Key Words: Interleukin • cytokine • preterm labor • tocolysis.

Journal of the Society for Gynecologic Investigation, Vol. 1, No. 4, 264-268 (1994)
DOI: 10.1177/107155769400100404
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