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Licensed Unlicensed Requires Authentication Published by De Gruyter September 13, 2005

Special relationships between fetal inflammatory response syndrome and bronchopulmonary dysplasia in neonates

  • Robert Mittendorf , Robert Covert , Anthony G. Montag , Wafic elMasri , Jonathan Muraskas , Kwang-Sun Lee and Peter G. Pryde

Abstract

Objective: To confirm previous known relationships between Fetal Inflammatory Response Syndrome (FIRS) and neonatal bronchopulmonary dysplasia (BPD) and to present information on previously unknown special relationships between inflammatory variables and BPD.

Study design: At delivery, we obtained biological specimens including umbilical cord venous blood for plasma interleukin-6 levels, as well as placental histology and bacteriology. Among other neonatal outcomes, we collected prospective information on BPD.

Results: Of 141 newborns in the study, 16 had BPD; 79% of these had antecedent FIRS, 27% of those without FIRS had BPD. By multivariable regression, only very low birth weight (adjusted [adj] odds ratio [OR] 32.0, 95% Confidence Interval [CI] 5.0 to positive infinity) and FIRS (adj OR 5.7, 95% CI 1.1 to 42.3) remained significant risk factors. Escherichia coli, perhaps due to its pyogenic nature (strongly elicits inflammatory responses), may have had a special relationship with BPD.

Conclusions: In our data, FIRS and neonatal BPD are highly associated. It is possible that certain pyogenic bacteria in the chorioamnion space may be implicated more often than others.

Condensation: Neonates having Fetal Inflammatory Response Syndrome at delivery may later develop BPD. Pyogenic bacteria, such as Escherichia coli, may be implicated more frequently.

Keywords: BPD; FIRS
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Corresponding author: Dr. Robert Mittendorf Department of Obstetrics and Gynecology Loyola University Medical Center 2160 First Avenue, Maywood, IL 60153/USA Tel.: +708-216-2465 Fax: +708-216-5669

References

1 Bancalari E: Epidemiology and risk factors for the “new” bronchopulmonary dysplasia. NeoReviews1 (2000) e210.1542/neo.1-1-e2Search in Google Scholar

2 Doellner H, KJ Arntzen, PE Haereid, S Aag, R Austgulen: Interleukin-6 concentrations in neonates evaluated for sepsis. J Pediatr132 (1998) 295Search in Google Scholar

3 Eber E, MS Zach: Long term sequelae of bronchopulmonary dysplasia (chronic lung disease of infancy). Thorax56 (2001) 317Search in Google Scholar

4 Foca M, K Jakob, S Whittier, P Della Latta, S Factor, D Rubenstein, et al.: Endemic Pseudomonas aeruginosa infection in a neonatal intensive care unit. N Engl J Med343 (2000) 695Search in Google Scholar

5 Groneck P, B Gotze-Speer, M Oppermann, H Eiffert, CP Speer: Association of pulmonary inflammation and increased microvascular permeability during the development of bronchopulmonary dysplasia: a sequential analysis of inflammatory mediators in respiratory fluids of high-risk preterm neonates. Pediatrics93 (1994) 712Search in Google Scholar

6 Hillier SL, J Martius, M Krohn, N Kiviat, EK Holmes, DA Eschenbach: A case- control study of chorioamnionic infection and histologic chorioamnionitis in prematurity. N Engl J Med319 (1988) 972Search in Google Scholar

7 Holtzman RB, JR Hageman, R Yogev: Role of Ureaplasma urealyticum in bronchopulmonary dysplasia. J Pediatr114 (1989) 1061Search in Google Scholar

8 Mittendorf R, R Covert, J Boman, B Khoshnood, KS Lee, M Siegler: Is tocolytic magnesium sulphate associated with increased total pediatric mortality? Lancet350 (1997) 1517Search in Google Scholar

9 Mittendorf R, R Covert, R Elin, PG Pryde, B Khoshnood, K-S Lee: Umbilical cord serum ionized magnesium level and total pediatric mortality. Obstet Gynecol98 (2001) 75Search in Google Scholar

10 Mittendorf R, R Covert, J Kohn, N Roizen, B Khoshnood, KS Lee: The association of coagulase-negative staphylococci isolated from the chorioamnion at delivery and subsequent development of cerebral palsy. J Perinatol21 (2001) 3Search in Google Scholar

11 Mittendorf R, J Dambrosia, O Dammann, PG Pryde, K-S Lee, TE Ben-Ami, et al.: Association between maternal serum ionized magnesium levels at delivery and neonatal intraventricular hemorrhage. J Pediatr140 (2002) 540Search in Google Scholar

12 Mittendorf R, J Dambrosia, PG Pryde, KS Lee, JG Gianopoulos, R Besinger, et al.: Association between use of antenatal magnesium sulfate in preterm labor and adverse health outcomes in children. Am J Obstet Gynecol186 (2002) 1111Search in Google Scholar

13 Mittendorf R, S Janeczek, M Koh, W MacMillan, R Karlman, R Besinger, et al.: Association between specific bacteria cultured from the placenta at delivery and increased levels of fetal interleukin-6 (IL-6) (Abstract.) Am J Obstet Gynecol189 (2003) S15210.1016/j.ajog.2003.10.330Search in Google Scholar

14 Mittendorf R, AG Montag, W MacMillan, S Janeczek, PG Pryde, RE Besinger: Components of the systemic fetal inflammatory response syndrome as predictors of impaired neurologic outcomes in children. Am J Obstet Gynecol188 (2003) 1438Search in Google Scholar

15 Mittendorf R, N Roizen, AH Moawad, B Khoshnood, KS Lee: Association between cerebral palsy and coagulase-negative staphylococci. Lancet354 (1999) 1875Search in Google Scholar

16 Mittendorf R, MA Williams, EH Kass: Prevention of preterm delivery and low birth weight associated with asymptomatic bacteriuria. Clin Infect Dis14 (1992) 927Search in Google Scholar

17 Niu JO, UK Munshi, MM Siddiq, LA Parton: Early increase in endothelin-1 in tracheal aspirates of preterm infants: correlation with bronchopulmonary dysplasia. J Pediatr132 (1998) 965Search in Google Scholar

18 Northway WH Jr, RC Rosan, DY Porter: Pulmonary disease following respirator therapy of hyaline-membrane disease. Bronchopulmonary dysplasia. N Engl J Med276 (1967) 357Search in Google Scholar

19 Rozycki HJ: Oxygen, oxygen radicals, and inflammation in the development of chronic lung disease. Tufts University School of Medicine and Floating Hospital for Children Reports on: Neonatal Respiratory Diseases 12 (2002) 1Search in Google Scholar

20 Stiskal JA, MS Dunn, AT Shennan, KK O'Brien, EN Kelly, RI Koppel, et al.: alpha 1-Proteinase inhibitor therapy for the prevention of chronic lung disease of prematurity: a randomized, controlled trial. Pediatrics101 (1998) 89Search in Google Scholar

21 Stoll BJ, N Hansen, AA Fanaroff, LL Wright, WA Carlo, RA Ehrenkranz, et al.: Changes in pathogens causing early-onset sepsis in very-low-birth-weight infants. N Engl J Med347 (2002) 240Search in Google Scholar

22 Vaucher YE: Bronchopulmonary dysplasia: an enduring challenge. Pediatr Rev23 (2002) 34910.1542/pir.23.10.349Search in Google Scholar

23 Watterberg KL, LM Demers, SM Scott, S Murphy: Chorioamnionitis and early lung inflammation in infants in whom bronchopulmonary dysplasia develops. Pediatrics97 (1996) 210Search in Google Scholar

24 Welty SE: Is oxidant stress in the causal pathway to bronchopulmonary dysplasia? NeoReviews1 (2000) e610.1542/neo.1-1-e6Search in Google Scholar

25 Yoon BH, R Romero, JK Jun, KH Park, JD Park, F Ghezzi, et al.: Amniotic fluid cytokines (interleukin-6, tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-8) and the risk for the development of bronchopulmonary dysplasia. Am J Obstet Gynecol177 (1997) 825Search in Google Scholar

26 Yoon BH, R Romero, KS Kim, JS Park, SH Ki, BI Kim, et al.: A systemic fetal inflammatory response and the development of bronchopulmonary dysplasia. Am J Obstet Gynecol181 (1999) 773Search in Google Scholar

27 Yoon BH, R Romero, JS Park, M Kim, SY Oh, CJ Kim, et al.: The relationship among inflammatory lesions of the umbilical cord (funusitis), umbilical cord plasma interleukin 6 concentration, amniotic fluid infection, and neonatal sepsis. Am J Obstet Gynecol183 (2000) 1124Search in Google Scholar

Published Online: 2005-09-13
Published in Print: 2005-10-01

©2005 by Walter de Gruyter Berlin New York

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