Article Text

Download PDFPDF
Oral Presentations
Cervical-vaginal fluid elafin concentrations and subsequent cervical shortening in women at high risk of spontaneous preterm birth
  1. D Abbott,
  2. EC Chin-Smith,
  3. P Seed,
  4. M Chandiramani,
  5. AH Shennan
  1. RM Tribe Maternal and Fetal Research Unit, Women's Health Academic Centre, King's College London and Health Partners, London, United Kingdom


Introduction Elafin, a natural antimicrobial peptide, is an important component of the innate immune system. It is hypothesised that elafin production in cervico-vaginal fluid (CVF) will be altered in women at risk of spontaneous preterm birth (sPTB) associated with inflammation/infection.

Aim To determine the relationship between CVF elafin concentrations and cervical length in women at high risk of sPTB.

Methods Elafin concentrations were measured in 437 CVF samples (taken two-weekly between 14-28 weeks') from 74 pregnant women (asymptomatic, high risk for sPTB).

Controls women who did not develop a short cervix (n=38); cases: women who developed a short cervix <25mm, n=36) and were randomised to either cerclage or vaginal progesterone (400 mg/od). Elafin was measured by ELISA. Logged data were analysed using random-effects interval regression.

Results Concentrations of elafin were higher in the CVF of the short cervix group, regardless of gestation and treatment (ratio 2.71, CI 1.94 to 3.79, p<0.0005). Elafin concentrations predicted cervical shortening from 14 weeks' (n=11, ROC area = 1.00, p=0.0082), and remained high when cervical shortening was first detected (ratio 3.03 CI 1.92-4.81, p<0.0005). Elafin concentrations were unaltered by cerclage or progesterone (ratio 1.28, CI: 0.88-1.87, p=0.196). Raised elafin concentrations <24 weeks' were associated with SPTB <37 weeks (ratio 1.79, CI: 1.05-3.05, p=0.034).

Conclusion These data suggest that CVF elafin concentrations may be useful for the early prediction of sPTB prior to cervical shortening.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.