CLIC: A Longitudinal Study of Inflammatory Markers and Cervical Change in Women at Risk of Spontaneous Preterm Labour

Background Infection is implicated in cervical shortening and spontaneous preterm labour (SPTL). Increased understanding of inflammatory events in the vaginal tract prior to cervical shortening is needed. The authors undertook a longitudinal observational study to determine the relation between inflammation and cervical shortening in women at risk of SPTL. Methods Women (n=112) with at least one previous preterm delivery were recruited (14–24-week gestation) from two prematurity clinics and assessed (transvaginal cervical scans and cervico-vaginal fluid (CVF) swabs) every 2 weeks until 28 weeks. If cervical length shortened ( Results Women destined to develop a short cervix (n=37) exhibited higher CVF concentrations of GM-CSF (15.6 times greater, CI 1.7 to 144, p=0.015) and MCP-1 (4.9, CI 1.03 to 23, p=0.045) at Conclusion GM-CSF and MCP-1 appear to be involved in processes leading to cervical shortening. Progesterone treatment has little impact on CVF markers of inflammation or cervical length.