Maternal intrauterine infection, cytokines, and brain damage in the preterm newborn

Pediatr Res. 1997 Jul;42(1):1-8. doi: 10.1203/00006450-199707000-00001.

Abstract

To evaluate the hypothesis that the proinflammatory cytokines IL-1, IL-6, and tumor necrosis factor-alpha might be the link between prenatal intrauterine infection (IUI) and neonatal brain damage, the authors review the relevant epidemiologic and cytokine literature. Maternal IUI appears to increase the risk of preterm delivery, which in turn is associated with an increased risk of intraventricular hemorrhage, neonatal white matter damage, and subsequent cerebral palsy. IL-1, IL-6, and TNF-alpha have been found associated with IUI, preterm birth, neonatal infections. and neonatal brain damage. Unifying models not only postulate the presence of cytokines in the three relevant maternal/fetal compartments (uterus, fetal circulation, and fetal brain) and the ability of the cytokines to cross boundaries (placenta and blood-brain barrier) between these compartments, but also postulate how proinflammatory cytokines might lead to IVH and neonatal white matter damage during prenatal maternal infection. Interrupting the proinflammatory cytokine cascade might prevent later disability in those born near the end of the second trimester.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Blood-Brain Barrier
  • Brain Injuries / etiology*
  • Brain Injuries / immunology
  • Cerebral Hemorrhage / etiology
  • Cerebral Palsy / etiology
  • Cytokines / physiology*
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Inflammation Mediators / physiology
  • Interleukin-1 / physiology
  • Interleukin-6 / physiology
  • Leukomalacia, Periventricular / etiology
  • Models, Biological
  • Placenta / physiopathology
  • Pregnancy
  • Pregnancy Complications, Infectious / immunology*
  • Tumor Necrosis Factor-alpha / physiology
  • Uterine Diseases / complications
  • Uterine Diseases / immunology

Substances

  • Cytokines
  • Inflammation Mediators
  • Interleukin-1
  • Interleukin-6
  • Tumor Necrosis Factor-alpha