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Notes: Objective To evaluate the predictive values of fetal fibronectin, bacterial vaginosis, endotoxin and cervical length for preterm birth (〈 35 and 〈 37 weeks) and neonatal morbidity in twin pregnancies.Participants One–hundred and twenty–one women with twin pregnancies recruited into a prospective longitudinal study at three antenatal clinics in the southwest of Sweden.Methods Cervical or vaginal fluid was sampled and determined for fetal fibronectin (〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:14700328:BJO1398:ges" location="ges.gif"/〉 0.05 μg/mL was used as cutoff), endotoxin (〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:14700328:BJO1398:ges" location="ges.gif"/〉 100 pg/mL) and bacterial vaginosis (presence of clue cells) at two week intervals from 24 to 34 weeks of gestation. The cervical length was measured with transvaginal sonography at the same time intervals.Main outcome measures Occurrence of preterm birth (〈 35 and 〈 37 weeks of gestation) and neonatal morbidity.Results All positive fetal fibronectin samples obtained at screening between 24 and 34 weeks predicted birth 〈 35 weeks (RR 18.0; 95% CI2.2–145.9). A positive fetal fibronectin at 28 weeks of gestation predicted delivery 〈 35 weeks (RR 6.3; 95% CI 2.6–15.1) with a sensitivity, specificity, positive and negative predictive value of 50.0, 92.0, 62.5 and 87.3%, respectively. An independent association between fetal fibronectin at 28 weeks and preterm birth (〈 35 weeks) was verified with logistic regression (P= 0.03). A positive fetal fibronectin at 28 weeks of gestation predicted neonatal morbidity (RR 5.1; 95% CI 2.4–11.0) and a longer period of care at the neonatal intensive care unit. The predictive power of cervical sonography was generally low but cervical length (cutoff 〈inlineGraphic alt="leqslant R: less-than-or-eq, slant" extraInfo="nonStandardEntity" href="urn:x-wiley:14700328:BJO1398:les" location="les.gif"/〉 33 mm) measured at 28 weeks of gestation was significantly associated with birth 〈 37 weeks (RR 2.2; 95% CI 1.1–4.2). The presence of endotoxin correlated to bacterial vaginosis, but these tests were not significantly related to preterm birth or neonatal morbidity.Conclusions Fetal fibronectin predicted preterm birth and neonatal morbidity in twin pregnancies. The predictive value of cervical length determinations was low. Endotoxin and bacterial vaginosis had no predictive power for preterm delivery in this study.

Notes: Abstract Uninary tract infections (UTI) are common, with frequencies ranging from about 1 to 10% in different age groups, Gram-negative bacteria dominate as causative agents. Defects in host resistance to bacteriuria have not been defined at the molecular level. The results of the present study demonstrate that endotoxin-induced inflammation mediates bacterial clearance from the kidneys. Genetic or pharmacologically induced defects in this function drastically impaired the natural resistance to infection.

Notes: In this study, we investigated the anti-inflammatory effects of orally administered human lactoferrin (hLF) and two peptides, based on the bactericidal region of hLF (HLD1 and HLD2), on the course of experimental colitis. Acute colitis was induced in C57Bl/6 mice by giving 5% dextran sulphate (DX) in the drinking water. The mice were killed after 2 or 7 days of DX exposure. The animals were given hLF or the peptides orally twice a day (2 mg/dose/mouse) during the DX exposure. In the control animals, the hLF or the peptides were replaced by bovine serum albumin or water.The appearance of occult blood in the faeces and macroscopic rectal bleeding were significantly delayed and partly reduced in the hLF-treated animals compared with the control animals. The shortening of the colon, a pathological effect of DX exposure, was significantly less pronounced in the hLF-treated group compared with the control group. Also, the interleukin-1β (IL-1β) levels in the blood were significantly diminished in this group after 2 days of DX exposure. A significantly lower crypt score was observed in the distal part of the colon in the hLF-treated group compared with the control group. Also, significantly reduced numbers of CD4 cells, F4/80-positive macrophages and tumour necrosis factor-α-producing cells were detected by immunohistochemistry in the distal colon of the hLF-treated animals compared with the control animals after 7 days of DX exposure. A reduction was also observed concerning the IL-10-producing cells in the middle colonic submucosa. The HLD1 and HLD2 treatment, which was carried out for 2 days, only gave results almost identical to those of hLF, concerning clinical parameters after the 2 days of DX exposure. An even stronger effect was observed for HLD2, regarding decreased occult blood in the faeces and colon length.Our results show that perorally given hLF mediates anti-inflammatory effects on the DX-induced acute colitis, and further suggest that the bactericidal region of the hLF molecule may be involved in these activities.