Inflammatory predictors of neurologic disability after preterm premature rupture of membranes.
Inflammatory predictors of neurologic disability after preterm premature rupture of membranes.
复制标题
早产过早破裂后神经系统残疾的炎症预测因子。
DOI：
10.1016/j.ajog.2014.09.016
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发表时间：
2015-02
影响因子：
9.8
通讯作者：
Sebire, Guillaume
中科院分区：
文献类型：
--
作者：
Armstrong-Wells, Jennifer;Donnelly, Meghan;Post, Miriam D.;Manco-Johnson, Marilyn J.;Winn, Virginia D.;Sebire, Guillaume
母胎炎症反应导致早产胎膜早破（PPROM）和不良神经学结局。此外，与胎儿胎盘炎症相关的细胞因子可能对大脑发育有害，无论是否引发感染。我们研究了母亲和胎儿血浆样本中细胞因子标志物的差异模式是否反映了PPROM母亲所生婴儿6个月时胎盘炎症和神经学结局的亚型。在25例PPROM患者的前瞻性队列研究中，通过ELISA检测破裂和分娩时母体血液样本和胎儿脐带血样本的血浆细胞因子（IL-1β、IL-6、IL-8和TNF-α）。细胞因子表达模式与特定胎盘病理相关。婴儿出生后接受颅超声检查，并在6个月矫正胎龄时进行标准化神经系统检查。炎症和不良神经学结局的预测因子通过logistic回归进行评估，校正出生时的胎龄。胎盘胎儿侧的炎症与分娩时母体IL-6和IL-8以及胎儿IL-1β、IL-6、IL-8和TNF-α升高相关。6个月时神经系统结局较差与胎盘胎儿侧炎症和胎膜破裂至分娩的持续时间较短相关，与出生时胎龄或头颅超声结果无关。我们的研究结果支持胎儿炎症与PPROM不良神经系统结局之间的联系，无论头颅超声结果如何。需要进一步的纵向研究来充分检查这些模式，并将有助于风险评估和干预策略。
The maternal-fetal inflammatory response contributes to both preterm premature rupture of membranes (PPROM) and adverse neurological outcomes. Additionally, cytokines associated with fetal placental inflammation can be detrimental to brain development regardless of inciting infection. We investigated whether differential patterns of cytokine markers in maternal and fetal plasma samples reflect subtypes of placental inflammation and neurological outcomes at 6 months in infants born to mothers with PPROM. Within a prospective cohort study of 25 women with PPROM, plasma cytokines (IL-1β, IL-6, IL-8, and TNF-α) were measured by ELISA from maternal blood samples at rupture and delivery, and from fetal umbilical cord blood samples. Patterns of cytokine expression were correlated with specific placenta pathologies. Infants underwent cranial ultrasound after birth and standardized neurological examinations at 6 months corrected gestational age. Predictors of inflammation and adverse neurological outcome were assessed by logistic regression, adjusting for gestational age at birth. Inflammation of the fetal side of the placenta was associated with elevated maternal IL-6 and IL-8 at delivery and fetal IL-1β, IL-6, IL-8, and TNF-α. Worse neurological outcome at 6 months was associated with inflammation of the fetal side of the placenta and shorter duration from rupture of membrane to delivery, independent of gestational age at birth or cranial ultrasound results. Our findings support the connection between fetal inflammation with adverse neurological outcome with PPROM, regardless of cranial ultrasound results. Further longitudinal studies are needed to adequately examine these patterns, and will aid in risk assessment and intervention strategies.
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影响因子：
8.3
作者：
Kitchen, Lisa;Westmacott, Robyn;deVeber, Gabrielle
通讯作者：
deVeber, Gabrielle
影响因子：
9.8
作者：
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通讯作者：
Sebire, Guillaume
DOI：
10.3109/14767058.2011.638952
发表时间：
2012-08-01
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作者：
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作者：
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通讯作者：
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作者：
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通讯作者：
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