Differences in Inflammatory Markers between Nulliparous Women Admitted to Hospitals in Preactive vs Active Labor
Format of Original
American Journal of Obstetrics and Gynecology
Original Item ID
To determine whether labor-associated inflammatory markers differ between low-risk, nulliparous women in preactive vs active labor at hospital admission and over time.
Prospective comparative study of low-risk, nulliparous women with spontaneous labor onset at term (n = 118) sampled from 2 large Midwestern hospitals. Circulating concentrations of inflammatory markers were measured at admission and again 2 and 4 hours later: namely, neutrophil, and monocyte counts; and serum inflammatory cytokines (interleukin -1β, interleukin-6, tumor necrosis factor-α, interleukin-10) and chemokines (interleukin-8). Biomarker concentrations and their patterns of change over time were compared between preactive (n = 63) and active (n = 55) labor admission groups using Mann-Whitney U tests.
Concentrations of interleukin-6 and interleukin-10 in the active labor admission group were significantly higher than concentrations in the preactive labor admission group at all 3 time points. Neutrophil levels were significantly higher in the active group at 2 and 4 hours after admission. The rate of increase in neutrophils and interleukin-10 between admission and 2 hours later was faster in the active group (P < .001 and P = .003, respectively).
Circulating concentrations of several inflammatory biomarkers are higher and their rate of change over time since admission is faster among low-risk, nulliparous women admitted to hospitals in active labor, as compared with those admitted in preactive labor. More research is needed to determine if progressive changes in inflammatory biomarkers might be a useful adjunct to improving the assessment of labor progression and determining the optimal timing of labor admission.
Neal, Jeremy L.; Lamp, Jane M.; Lowe, Nancy; Gillespie, Shannon L.; Sinnott, Loraine T.; and McCarthy, Donna O., "Differences in Inflammatory Markers between Nulliparous Women Admitted to Hospitals in Preactive vs Active Labor" (2015). College of Nursing Faculty Research and Publications. 356.
Accepted version. American Journal of Obstetrics and Gynecology, Vol. 212, No. 1 (January 2015): 68.e1–68.e8. DOI. © 2015 Elsevier Inc. Used with permission.