Daraï Emile, Poncelet Christophe, Soriano David, Lejeune Veronique, Bringuier Annie-France, Madelenat Patrick, Feldmann Gerard, Scoazec Jean-Yves
Service de Gynécologie-Obstétrique, Hôpital Bichat-Claude-Bernard, Paris, France.
Fetal Diagn Ther. 2002 May-Jun;17(3):167-72. doi: 10.1159/000048032.
To evaluate the diagnostic relevance to neonatal infections of the soluble intercellular adhesion molecule 1 (sICAM-1) cord serum level.
The case-control study included 66 term newborn infants with and without risk factors for neonatal infections. Cord blood serum determinations of white blood cell count, C-reactive protein, fibrinogen, and sICAM-1 were systematically performed associated with bacterial cultures from placenta, ears, and gastric fluids.
6 of 33 infants (18.2%) with risk factors were infected, and 13 (39.4%) were colonized. Two infants included in the group without infection risk factors (n = 33) were colonized. No difference in sICAM-1 cord serum levels was found according to the presence of premature rupture of membrane, fetal tachycardia >160 bpm, meconial amniotic fluid, and duration of labour >10 h. No difference in sICAM-1 was noted between infected and non-infected infants. The cord serum levels of sICAM-1 were significantly higher in infants after forceps extraction (p = 0.01). A correlation was observed between sICAM-1 and C-reactive protein cord serum levels (p = 0.004, r = 0.371) and between sICAM-1 level and neutrophil count (p = 0.01, r = 0.489).
Our results suggest that cord serum sICAM-1 determinations have no diagnostic relevance to neonatal infection. The increase of sICAM-1 cord serum levels in infants after forceps extraction suggests its potential to evaluate cerebral trauma or hypoxia.
评估可溶性细胞间黏附分子1（sICAM - 1）脐血血清水平对新生儿感染的诊断相关性。
该病例对照研究纳入了66例足月新生儿，其中部分新生儿有新生儿感染风险因素，部分没有。系统检测了脐血血清中的白细胞计数、C反应蛋白、纤维蛋白原和sICAM - 1，并与胎盘、耳部和胃液的细菌培养结果相关联。
33例有风险因素的婴儿中，6例（18.2%）发生感染，13例（39.4%）有细菌定植。在无感染风险因素的33例婴儿中，有2例发生细菌定植。根据胎膜早破、胎儿心动过速>160次/分、羊水胎粪污染和产程>10小时的情况，sICAM - 1脐血血清水平无差异。感染婴儿与未感染婴儿的sICAM - 1水平无差异。产钳助产的婴儿脐血血清sICAM - 1水平显著更高（p = 0.01）。观察到sICAM - 1与C反应蛋白脐血血清水平之间存在相关性（p = 0.004，r = 0.371），以及sICAM - 1水平与中性粒细胞计数之间存在相关性（p = 0.01，r = 0.489）。
我们的结果表明，脐血血清sICAM - 1检测对新生儿感染无诊断相关性。产钳助产婴儿脐血血清sICAM - 1水平升高表明其有评估脑损伤或缺氧的潜力。
