Amniotic fluid interleukin-6 increase is an indicator of spontaneous preterm birth in white but not black Americans

Objective: This study examined the differences in the inflammatory cytokine interleukin (IL)-6 and the immunoinhibitory cytokine IL-10 in the amniotic fluid of black and white women in spontaneous preterm birth. Methods: In this study, 321 amniotic fluids from cases (preterm birth 36 or fewer weeks' gestation) and controls (normal term delivery longer than 37 weeks' gestation) were collected (147 cases [49 blacks and 98 whites] and 174 controls [85 blacks and 89 whites]) at the time of active labor. IL-6 and IL-10 concentrations were measured by immunoassays. Using normal-term delivery as controls, logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CIs) for preterm birth. Results: A significant difference in IL-6 concentration was observed in white cases (cases: 3773 pg/mL; controls: 1682 pg/mL; P = .0003), compared with controls, but not in blacks (cases: 2042 pg/mL; controls: 2366 pg/mL; P = .6). In a combined multivariable analysis, when the highest and the lowest quartiles of IL-6 were compared in whites, the ORs (95% CI) for preterm birth across quartiles were 1.74 (0.62-4.88), 1.09 (0.39-3.02), and 5.68 (2.15-15.0). No such association was found in blacks. IL-10 concentration was not different between cases and controls in either race. Conclusions: Race-specific associations exist between IL-6 but not IL-10 concentration and preterm birth. Elevated IL-6 concentrations are associated with preterm birth in whites but not blacks.