ORAL CONDITIONS AND PREGNANCY--NEONATAL OUTCOMES

这一补充应用将口腔炎症和感染、对妊娠的影响的评估扩展到对早产儿的潜在影响以及早产、肺和脑损伤等主要并发症。一般的假设是，亚临床感染可能起源于牙周病，影响女性的炎症和免疫反应，使她们面临早产和分娩的更高风险。与牙周病和宫内感染相关的促炎细胞因子与早产的开始有关。我们建议的研究将评估这些母体过程如何影响早产低出生8岁婴儿的炎症级联反应，以及早产儿炎性并发症的风险。出生前感染和炎症与早产儿的脑损伤有关，特别是脑室出血和脑室周围白质软化。在早产儿的气管分泌物中发现了炎性细胞因子，这些早产儿后来发展为支气管肺发育不良。坏死性小肠结肠炎是另一种严重威胁生命的早产儿并发症，与促炎细胞因子升高有关。编码IL-1β和TNFpha的基因多态性与细胞因子表达增加相关，并可能倾向于夸大炎症反应。我们将测量孕妇的促炎细胞因子，并将其与早产儿的细胞因子进行比较。通过Logistic回归分析，细胞因子将与早产儿的炎性并发症相关：支气管肺发育不良、脑室出血/脑室周围白质软化症和坏死性小肠结肠炎。这些炎症并发症的多态与气管抽吸物细胞和血液中细胞因子蛋白和信使核糖核酸的丰度有关。我们将测试一组调解人是否具有高度的敏感性和特异性。我们的长期目标是开发识别高危新生儿的标志物，并为未来预防这些早产儿并发症的治疗提供基础。

This supplemental application extends the evaluation of oral inflammation and infection, effects on pregnancy to the potential impact on premature newborns and the leading complications of prematurity, lung and brain damage. The general hypothesis is that subclinical infection, possibly originating in periodontal disease, affects the inflammatory and immune responses in women, placing them at higher risk for preterm labor and delivery. Pro-inflammatory cytokines, associated with periodontal disease and intrauterine infection, have been implicated in the initiation of preterm labor. Our proposed studies will assess how these maternal processes affect the inflammatory cascade in the premature low birth eight infant and the risk for inflammatory complication of prematurity. Prenatal infection and inflammation are associated with brain injury in premature newborns, in particular intraventricular hemorrhage and periventricular leukomalacia. Inflammatory cytokines are found in the tracheal secretions of premature newborns who later develop bronchopulmonary dysplasia. Necrotizing enterocolitis is another serious life-threatening complication of prematurity associated with elevations in pro-inflammatory cytokines. Genetic polymorphisms encoding IL-1beta and TNFalpha are associated with increased cytokine expression and may predispose to an exaggerated inflammatory response. We will measure pro-inflammatory cytokines in pregnant women and compare them to those in their premature newborns. Cytokines will be correlated with the inflammatory complications of prematurity: bronchopulmonary dysplasia, intraventricular hemorrhage/periventricular leukomalacia, and necrotizing enterocolitis, using logistic regression analysis. Polymorphisms will be identified and correlated with these inflammatory complications with the abundance of cytokine protein and mRNA in tracheal aspirates cells and in blood. We will test whether a panel of mediators identified at risk with high sensitivity and specificity. Our long-term aim is to develop markers that identify newborns at highest risk and provide the basis for future therapy to prevent these complications of prematurity.