Evidence for fetal involvement in the pathologic process of clinical chorioamnionitis
Evidence for fetal involvement in the pathologic process of clinical chorioamnionitis
复制标题
DOI：
10.1067/mob.2002.124042
复制
发表时间：
2002-06-01
影响因子：
9.8
通讯作者：
Gomez, R
中科院分区：
文献类型：
--
作者：
Chaiworapongsa, T;Romero, R;Gomez, R
目的：临床和组织学绒毛膜炎最近被确定为脑性瘫痪的危险因素。促炎性细胞因子已被牵连的机制，是负责脑损伤的情况下，宫内感染。本研究的目的是确定临床绒毛膜炎，这是一种母体综合征，是否与胎儿血浆白细胞介素-6（IL-6）的升高有关，这是胎儿炎症的指标。本研究采用横断面研究的方法，测定了26例临床绒毛膜炎患者和26例对照组脐静脉血中IL-6的血浆浓度。111）。分娩时采集脐带血。用灵敏和特异的免疫测定法测定IL-6的血浆浓度。结果：所有脐静脉血标本均检测到IL-6的浓度。患有临床绒毛膜炎的母亲所生新生儿的血浆IL-6浓度中位数高于对照组母亲所生新生儿（临床绒毛膜炎：中位数，27.46 pg/mL;范围，1.3-5550.0 pg/mL; vs对照组：中位数，2.13 pg/mL;范围，0.6-812.3 pg/mL; P <0.001）。62%（16/26）临床绒毛膜炎孕妇所生新生儿的胎儿血浆IL-6浓度>11 pg/mL，54%（14/26）胎儿血浆IL-6浓度>18 pg/mL（这些临界点以前已被用于定义胎儿炎症反应综合征）。白细胞介素-6的脐静脉血浆浓度升高的新生儿谁出生的母亲临床绒毛膜炎，这表明，炎症过程，是负责临床绒毛膜炎的母亲综合征往往涉及胎儿。
OBJECTIVE: Clinical and histologic chorioamnionitis have recently been identified as risk factors for cerebral palsy. Proinflammatory cytokines have been implicated in the mechanisms that are responsible for brain injury in cases of intrauterine infection. The purpose of this study was to determine whether clinical chorioamnionitis, which is a maternal syndrome, is associated with an elevation in the fetal plasma interleukin-6 (IL-6) that is indicative of fetal inflammation.STUDY DESIGN: A cross-sectional study was designed to determine plasma concentrations of IL-6 in umbilical venous blood from patients with clinical chorioamnionitis (n = 26) and a control group (n = 111). Umbilical cord blood was obtained at the time of delivery. Plasma concentrations of IL-6 were measured with a sensitive and specific immunoassay. Nonparametric statistics were used for analysis.RESULTS: Plasma concentrations of IL-6 were detectable in all samples of umbilical venous plasma. The median concentration of plasma IL-6 was higher in neonates born to mothers with clinical chorioamnionitis than in neonates born to mothers in the control group (clinical chorioamnionitis: median, 27.46 pg/mL; range, 1.3-5550.0 pg/mL; vs control: median, 2.13 pg/mL; range, 0.6-812.3 pg/mL; P < .001). Sixty-two percent of neonates (16/26) who were born to women with clinical chorioamnionitis had fetal plasma concentrations of IL-6 >11 pg/mL and 54% (14/26) had fetal plasma concentrations of IL-6 >18 pg/mL (these cutoff points have been used previously to define the fetal inflammatory response syndrome).CONCLUSION: Umbilical vein plasma concentrations of interleukin-6 are elevated in the neonates who were born to mothers with clinical chorioamnionitis, which suggests that the inflammatory process that is responsible for the maternal syndrome of clinical chorioamnionitis frequently involves the human fetus.