A Clinical Randomized Trial on Endocervical Inflammatory Cytokines and Betamethasone in Prime-Gravid Pregnant Women at Risk of Preterm Labor

Background: There are strong evidences suggesting the secretion of different cytokines in cervical fluid during preterm labor. Betamethasone is widely administered for several reasons in preterm conditions. Objective: To Investigate the possible effect of betamethasone on endocervical cytokine concentration of women at risk of preterm labor. Methods: In a randomized clinical trial of 80 prime-gravid women in preterm labor between 34 and 37 weeks of gestation, cervical fluid was collected. Endocervical concentration of inflammatory cytokines were analyzed before and 48 hours after betamethasone treatment for the evaluation of IL-8, IL-17, IFN-γ and TGF-β. Wilcoxon and Mann-Whitney tests were employed for statistical analysis. χ2 and Student’s t tests were used whenever needed. Results: All the measured cytokines showed significant changes in the betamethasone treated group. IL-17 (p=0.001), IL-8 (p=0.001), and IFN- γ (p<0.05) decreased significantly, while TGF-β had a significant increase (p<0.05). In the patients who delivered before or on the 7th day of admission, IL-17, IL-8, and IFN-γ levels were all significantly higher. However, TGF-β decreased significantly in the same samples in the betamethasone treated group (p<0.05). Conclusion: Betamethasone significantly decreases the endocervical pro-inflammatory cytokine concentrations in patients with preterm labor.