Abstract
Background: Histological findings of chorioamnionitis and funisitis are frequent in both premature and term deliveries. Aims: (i) to study the difference between the degree and the localization of inflammation in placenta and umbilical cord and; (ii) the difference in cytokine response in premature and mature newborns.
Methods: In 94 premature newborns born between 23+0–30+6 (median 28+6) g.a. and 20 term newborns 39+1 − 41+6 (median 40+3) g.a., histological examinations of placenta and umbilical cord were performed with special regard to the localization and the degree of inflammatory infiltration (criteria by Salafia–modified). Umbilical serum levels of IL-1beta, IL-6 and IL8 were measured (ELISA) and compared between groups.
Results: Histological signs of prenatal inflammation occured more frequetly in premature than in mature newborns: chorioamnionitis 70 vs 55 % (p< 0,05) and funisitis 44 vs 25 % (p< 0,05). The difference was even more pronounced in severe chorioamnionitis 57 vs 30 % (p< 0,01) and severe funisitis 26 vs 0 % (p< 0,01). Umbilical serum IL-1beta, IL-6 and IL-8 levels were higher in premature newborns (all p< 0,05).
Discussion: Higher occurrence of chorioamnionitis and funisitis in premature infants and particularly higher occurrence of their more advanced stages signals higher risk of fetal inflammation in this pupolation. This finding is further supported by higher levels of umbilical serum proinflammatory cytokines. Fetal inflammatory response interferes with adaptation and development of premature infants. Speculation: Histological semi-quantitative scoring of inflammation in placenta and umbilical cord with special regard to more advanced stages may be useful in evaluation of the perinatal treatment strategies like ATB use, timing of delivery etc. Study was supported by by the grant of IGA MZ ER No. NE 6435.
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Kopecky, P., Ruffer, J., Sebron, V. et al. 138 Prenatal Inflammation and Fetal Response in Premature and Term Infants. Pediatr Res 56, 487 (2004). https://doi.org/10.1203/00006450-200409000-00161
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DOI: https://doi.org/10.1203/00006450-200409000-00161