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Related Experiment Videos

The fetal inflammatory response syndrome

R Gomez1, R Romero, F Ghezzi

  • 1Perinatology Research Branch, National Institute of Child Health and Human Development, Detroit, Michigan 48201, USA.

American Journal of Obstetrics and Gynecology
|August 15, 1998
PubMed
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Elevated fetal plasma interleukin-6 indicates a systemic inflammatory response in fetuses experiencing preterm labor or membrane rupture. This inflammatory response is an independent predictor of severe neonatal morbidity, highlighting its clinical significance.

Area of Science:

  • Perinatal Medicine
  • Neonatology
  • Immunology

Background:

  • Preterm labor and preterm premature rupture of membranes (PPROM) are significant causes of neonatal morbidity.
  • A systemic fetal inflammatory response may contribute to adverse neonatal outcomes.
  • Interleukin-6 (IL-6) is a key mediator of inflammation.

Purpose of the Study:

  • To determine the frequency and clinical significance of a systemic fetal inflammatory response, defined by elevated fetal plasma IL-6 concentrations.
  • To assess the association between fetal IL-6 levels and the development of severe neonatal morbidity in fetuses with preterm labor or PPROM.

Main Methods:

  • Amniocentesis and cordocentesis were performed in 157 patients.
  • Fetal plasma and amniotic fluid IL-6 concentrations were measured.

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  • Statistical analyses included logistic regression to identify predictors of neonatal morbidity.

    • Main Results:

    • Severe neonatal morbidity occurred in 34.8% of survivors.
    • Fetuses who developed severe neonatal morbidity had significantly higher fetal plasma IL-6 concentrations (median 14.0 pg/mL vs 5.2 pg/mL).
    • An elevated fetal plasma IL-6 level (> 11 pg/mL) was an independent predictor of severe neonatal morbidity (OR 4.3), even after adjusting for gestational age and other factors.

    Conclusions:

    • A systemic fetal inflammatory response, indicated by elevated fetal plasma IL-6, is a significant risk factor for severe neonatal morbidity.
    • Measuring fetal plasma IL-6 may aid in identifying fetuses at high risk for adverse outcomes.