{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T16:27:20Z","timestamp":1789057640183,"version":"build-2803163510"},"reference-count":71,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T00:00:00Z","timestamp":1690416000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Rep Immunol"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Problem<\/jats:title><jats:p>To examine whether the severity of spontaneous preterm birth (SPTB) risk after rescue cerclage for acute cervical insufficiency (CI) is linked to\u00a0the degree of inflammatory response in the amniotic fluid (AF) based on the concentrations of various inflammatory proteins and prior obstetric history.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method of study<\/jats:title><jats:p>We conducted a retrospective cohort study of 65 singleton pregnant\u00a0women (17\u201325\u00a0weeks) who underwent rescue cerclage following the diagnosis of acute CI and were subjected to amniocentesis. EN\u2010RAGE, IL\u20106, IL\u20108, and IP\u201010 as inflammatory mediators and kallistatin, MMP\u20102\/8, and uPA as extracellular matrix remodeling\u2010related molecules were assayed in the AF using ELISA. The level of each inflammatory mediator was divided into quartiles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Intra\u2010amniotic inflammation (IAI; AF IL\u20106 level \u22652.6\u00a0ng\/mL) was independently associated with SPTB after cerclage placement. The odds of SPTB at\u00a0&lt;\u00a032\u00a0weeks, even after adjusting for confounders, increased significantly with each increasing quartile of baseline AF levels for each inflammatory mediator (<jats:italic>p<\/jats:italic> for trend\u00a0&lt;\u00a0.05). Kaplan\u2010Meier survival curves showed that the cerclage\u2010to\u2010delivery intervals were significantly shorter as the quartiles of AF EN\u2010RAGE and MMP\u20108 increased (log\u2010rank test, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.01 each). Neither previous term birth nor prior PTB was associated with SPTB risk or cerclage\u2010to\u2010delivery interval after rescue cerclage. Multiparous women who experience CI after term birth showed significantly elevated levels of MMP\u20108 and reduced kallistatin levels in the AF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with CI, SPTB risk (especially risk severity) after rescue cerclage is associated with the\u00a0degree of the inflammatory response in AF as well as the presence of IAI but not with prior obstetric history.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aji.13756","type":"journal-article","created":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T10:18:45Z","timestamp":1690453125000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Degree of expression of inflammatory proteins in the amniotic cavity, but not prior obstetric history, is associated with the risk severity for spontaneous preterm birth after rescue cerclage for cervical insufficiency"],"prefix":"10.1111","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3550-9686","authenticated-orcid":false,"given":"Kyo Hoon","family":"Park","sequence":"first","affiliation":[{"name":"Departments of Obstetrics and Gynecology Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyong\u2010No","family":"Lee","sequence":"additional","affiliation":[{"name":"Departments of Obstetrics and Gynecology Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Mi","family":"Im","sequence":"additional","affiliation":[{"name":"Departments of Obstetrics and Gynecology Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam South 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