Can sulfasalazine prevent infection-mediated pre-term birth in a murine model?

Problem: Sulfasalazine (SASP) blocks activation of nuclear factor-kappa B (NF-γB) in gestational tissues in vitro- one of the earliest signals in the inflammatory response. We hypothesized that the administration of SASP would reduce the rate of infection-mediated pre-term birth in a murine model. Method of study: CD-1 mice (n = 40) were assigned on gestational day (gd) 14.5 to 1 of 3 treatments: (1) Sham infection and vehicle; (2) 10⁴ CFU Escherichia coli and vehicle; or (3) 10⁴ CFU E. coli and SASP (150 mg/Kg daily). Mice were observed twice daily and deliveries prior to gd 18.5 were considered pre-term. Results: Significantly more mice delivered prior to gd 18.5 when infected with 10⁴ CFU E. coli than sham-infected mice (P < 0.001) and this effect was significantly reduced in mice also treated with SASP (P = 0.002). SASP also tended to increase litter size (P = 0.060) and significantly increased weight of pups born to dams with intrauterine infections (P = 0.001). Conclusion: SASP reduced rates of pre-term delivery and improved pregnancy outcomes for mice infected with 10⁴ CFU E. coli. This suggests that SASP has the potential to play a role in strategies to prevent pre-term birth in women.