Vaginal Alpha-Lipoic Acid shows an anti-inflammatory effect on the cervix, preventing its shortening after primary tocolysis. A pilot, randomized, placebo-controlled study.

Inflammation might be an important underlying cause of preterm birth. Our aim is to explore whether vaginal administration α-lipoic acid reduces cervical inflammation and shortening after primary tocolysis. Matherials and Methods: Singleton pregnancies between 24-30 weeks remaining undelivered after hospitalization for preterm labor were randomly allocated to placebo (20 women, 15 analyzed) or vaginal ALA 400 mg daily (20 women, 17 analyzed) for 30 days. A cervical swab to quantify pro-inflammatory (IL1, IL2, IL6, IL8, TNFα) and anti-inflammatory (IL4, IL10) cytokines as well as transvaginal ultrasound cervical length measurement (CL) were performed before and after treatment.,The % changes of pro-inflammatory cytokines do not differ between treatment groups, while IL4 significantly increases by vaginal ALA in comparison to placebo (118.0±364.3% vs. 29.9±103.5%, p = 0.012). Combined anti-inflammatory cytokines show same trend (292.5±208.5% vs. 64.5±107.4, p = 0.03). CL remains similar in vaginal ALA group (from 23.1±6.6 to 20.80±7.9 mm), while it significantly decreased in placebo group (from 20.4±6.5 to 13.8±7.5 mm, p < 0.001 vs. Baseline; p = 0.003 vs. vaginal ALA).,Vaginal ALA significantly stimulates anti-inflammatory ILs in the cervix of undelivered women after a preterm labor episode. This effect is associated with a stabilization of the CL.