Clinical and prognostic value of combined measurement of cytokines and vascular cell adhesion molecule-1 in premature rupture of membranes

Objective: To evaluate whether levels of interleukin 6 (IL-6), interleukin 8 (IL-8), and vascular cell adhesion molecule-1 (VCAM-1) in women with premature rupture of membranes (PROM) differ from those in women without PROM. Methods: An observational study of full-term primiparous pregnant women with PROM (PROM group) and those undergoing elective cesarean delivery (control group) was performed at a center in Yangzhou, China, between January 2003 and July 2006. IL-6, IL-8, and VCAM-1 levels were measured in maternal blood, cord blood, and amniotic fluid. A pathologic examination of fetal membranes was conducted. Results: The IL-6, IL-8, and VCAM-1 levels in maternal serum, amniotic fluid, and cord blood were significantly higher in the PROM group (n = 58) than in the control group (n = 38; P < 0.05 for all comparisons). In the PROM group, the levels increased with duration of membrane rupture (P < 0.05 for all). Women with chorioamnionitis had significantly higher levels than women without chorioamnionitis (P < 0.05 for all), and women with PROM whose newborns had low Apgar score (≤ 7) had higher levels than those whose newborns had a higher Apgar score (P < 0.05 for all). Conclusion: Combined measurements of IL-6, IL-8, and VCAM-1 might help to improve early diagnosis of PROM and chorioamnionitis, and to evaluate the prognosis of newborns.