Prediction Of Spontaneous Preterm Labor By Inflammatory Factors TLR2,MCP-1,and IL-6

Objective:Preterm birth is the leading cause of neonatal complications and deaths,but the causes and the mechanism of spontaneous preterm birth are still unclear,and there is no precise way to predict preterm birth.The purpose of this study was to investigate the correlation between TLR2,CMP-1,IL-6cytokines,gestational age,body mass index?BMI?,conception,education level,pregnancy,birth history and preterm birth.In this way,we can establish a multifactor analysis model for predicting preterm birth,look for indicators to predict preterm birth,and explore new methods for predicting preterm birth.Methods:We collected and centrifuged venous blood of 116 outpatients with 20²4 weeks of pregnancy from October 2016 to October 2017.Besides,we followed up and recorded the end of pregnancy week.The pregnant women who delivered during 28 to 36⁺⁶ weeks of pregnancy were selected as the case group,and the pregnant women who delivered after 37 weeks of pregnancy were selected as the control group.The rupture of membrane and the mode of delivery were recorded in the two groups.Through single factor analysis on the correlation between the pregnant age,BMI,mode of conception,the level of education,premature pregnancy history,concentration of TLR2,MCP-1,IL-6 and preterm birth,we established the logistic regression model to predict preterm birth by incorporating the equations,and plotted the ROC area to estimate the accuracy of preterm delivery.Results:1.18 cases of spontaneous premature delivery,70 cases of full-term birth,the average pregnancy week in the premature delivery group was 34.11±2.46weeks,and the average pregnancy week in the full term delivery group was39.58±1.07 weeks.2.The results of univariate analysis?1?The P values of age,BMI and education in the two groups are 1.05,0.57 and 0.19,all P values>0.05,and the difference is not statistically significant,which means that age,BMI and education are not related to preterm labor.?2?The P values of TLR2,MCP-1 and IL-6 in the two groups are<0.001,0.035,0.048,all P values<0.05,and the difference is statistically significant,which means that TLR2,MCP-1 and IL-6 are related to preterm labor.?3?The cases of premature rupture of membranes in the two groups are 8,12,and the P value was 0.024.The difference is statistically significant,and it is believed that premature rupture of the membranes leads to premature delivery.?4?Comparison of delivery modes between the two groups:the cases of vaginal delivery are 13,44,and the P value was 0.58.The difference is not statistically significant.It is considered that The options for preterm and term delivery are the same.3.The results of multivariable analysisThe logistic regression was used to analyze the six factors of pregnant woman's age,gestation,conception,concentration of IL-6,concentration of MCP-1,concentration of TLR2.The concentration of IL-6,concentration of TLR2 and the way of pregnancy are included in the regression model of preterm prediction,which can predict preterm labor.4.Accuracy results of ROC curveThe best definition of IL-6 is 140.33pg/ml,sensitivity 78%,specificity56%;The best definition of TLR2 was 2.76ng/ml,the sensitivity was 72%,and the specificity was 71%;The area of the joint model ROC curve is 0.852,the sensitivity is 83.3%,and the specificity is 78%.Conclusions:1.Preterm labor was associated with the concentration of important proinflammatory factors TLR2,MCP-1 and IL-6.The expression of three cytokines in the blood of pregnant women in the middle of pregnancy is increased and the inflammatory response is induced,which will lead to premature delivery.2.Preterm birth is associated with the way of pregnancy,and assisted reproductive technology?ART?is likely to lead to premature delivery.3.The multifactor logistic regression model has a good predictive value for preterm labor.