Association of preterm birth with sustained postnatal inflammatory response
Association of preterm birth with sustained postnatal inflammatory response
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DOI：
10.1097/aog.0b013e31817057fb
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发表时间：
2008-05-01
影响因子：
7.2
通讯作者：
Thorsen, Poul
中科院分区：
文献类型：
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作者：
Skogstrand, Kristin;Hougaard, David M.;Thorsen, Poul
目的：为了研究胎儿或新生儿炎症模式的基础上，25个炎症标志物的新生儿干血斑样本早产儿和足月儿，收集出生后几天。方法：干血斑样本160名新生儿进行了分析，为25个炎症标志物使用多重技术：26例极早产新生儿（妊娠32周前），平均6天抽取（95%置信区间[CI]，5-7天）; 52例早产儿（32-36周妊娠），在出生后平均5天（95% CI，5-6天）抽取; 82例足月出生（妊娠37周或之后），在出生后平均5天（95% CI，5-5天）抽取。在多变量模型中分析了与早产有统计学显著相关的标志物以及早产的母亲和新生儿危险因素。白细胞介素（IL）-1 β、IL-6、可溶性IL-6 r α、IL-8、基质金属蛋白酶-9和转化生长因子-β 1水平升高，IL-18、脑源性神经营养因子、和C反应蛋白与早产有关。母亲的危险因素只能解释IL-1 β的增加，而新生儿因素可以解释早产儿与足月儿相比，干血斑样本中炎性标志物的升高和降低。早产儿与足月儿的干血斑样本中炎症标志物水平的差异支持了以下假设：胎儿源性炎症可能是早产的原因。
OBJECTIVE: To investigate fetal or neonatal inflammatory patterns based on 25 inflammatory markers in neonatal dried blood spots samples from infants born preterm and term, collected several days after birth.METHODS: Dried blood spots samples from 160 neonates were analyzed for 25 inflammatory markers using multiplex technology: 26 neonates born very preterm (before 32 weeks of gestation), drawn at a mean 6 days (95% confidence interval [CI], 5-7 days) after birth; 52 born preterm (32-36 weeks of gestation), drawn at mean 5 days (95% CI, 5-6 days) after birth; and 82 born at term (at or after 37 weeks of gestation), drawn at mean 5 days (95% CI, 5-5 days) after birth. Markers statistically significantly associated with preterm birth were analyzed in multivariable model together with maternal and neonatal risk factors for preterm birth.RESULTS: Elevated levels of interleukin (IL)-1 beta, IL-6, soluble IL-6r alpha, IL-8, matrix metalloproteinase-9, and transforming growth factor-beta 1 and decreased levels of IL-18, brain-derived neurotrophic factor, and C-reactive protein were associated with preterm birth. Maternal risk factors could explain only an increase of IL-1 beta, whereas neonatal factors could explain several of the elevated and decreased inflammatory markers in the dried blood spots samples from the infants born preterm compared with the infants born at term.CONCLUSION: The differences in levels of inflammatory markers in dried blood spots samples from infants born preterm compared with infants born at term supports the hypothesis that inflammation of fetal origin might be a cause of preterm birth.