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晚期早产儿剖宫产与新生儿脐血中趋化因子浓度

Late-preterm cesarean delivery and chemokines concentration in the umbilical cord blood of neonates.

作者信息

Królak-Olejnik Barbara, Olejnik Igor

机构信息

2nd Department and Clinic of Gynaecology, Obstetrics and Neonatology, Wroclaw Medical University, Poland.

出版信息

J Matern Fetal Neonatal Med. 2012 Sep;25(9):1810-3. doi: 10.3109/14767058.2012.664194. Epub 2012 Mar 9.

Abstract

OBJECTIVE

The objective of the study was to investigate whether concentrations of chemokines in the umbilical cord blood of neonates are affected by delivery via cesarean section.

STUDY DESIGN

Umbilical cord blood was obtained from 116 singleton late-preterm and full-term neonates without infections, born to healthy pregnant women. Concentrations of chemokines - MIP-1α (CCL3), MIP-1β 1 (CCL4), RANTES (CCL5), GRO-α (CXCL1) and ENA-78 (CXCL5) - were measured by ELISA. Logistic regression was used to investigate regression relationships between the occurrence of neonatal chemokines concentrations in umbilical cord blood and mode and time of delivery.

RESULTS

Concentrations of CXC chemokines in late-preterm neonates were the same as those in term neonates. RANTES concentrations in late-preterm cord blood were significantly lower than concentrations in term cord blood. Concentrations of the CC chemokine - RANTES (CCL5) - were noted to be lower in neonates born to cesarean section than in neonates born vaginally. Any anesthetic taken by the mothers during cesarean section did not affect CC chemokine production in the cord blood of full-term neonates. In a logistic regression model including gestational age as a variable, late-preterm delivery was associated with RANTES concentrations (OR = 3.8). After adjustment for variable mode of delivery in regression model, RANTES concentration (OR = 4.75).

CONCLUSION

Both late-preterm and cesarean delivery are essential risk factors of low RANTES (CCL5) concentrations in the umbilical cord blood.

摘要

目的

本研究的目的是调查剖宫产分娩方式是否会影响新生儿脐带血中趋化因子的浓度。

研究设计

从116例单胎晚期早产儿和足月儿的脐带血中获取样本,这些新生儿的母亲均为健康孕妇且无感染情况。采用酶联免疫吸附测定法(ELISA)测量趋化因子——巨噬细胞炎性蛋白-1α(MIP-1α,CCL3)、巨噬细胞炎性蛋白-1β1(MIP-1β1,CCL4)、调节激活正常T细胞表达和分泌因子(RANTES,CCL5)、生长调节致癌基因-α(GRO-α,CXCL1)和上皮中性粒细胞激活肽78(ENA-78,CXCL5)的浓度。使用逻辑回归分析来研究脐带血中新生儿趋化因子浓度的出现与分娩方式和时间之间的回归关系。

结果

晚期早产儿中CXC趋化因子的浓度与足月儿相同。晚期早产脐带血中RANTES的浓度显著低于足月脐带血中的浓度。注意到剖宫产出生的新生儿中CC趋化因子——RANTES(CCL5)的浓度低于经阴道分娩的新生儿。剖宫产期间母亲使用的任何麻醉剂均未影响足月新生儿脐带血中CC趋化因子的产生。在一个将胎龄作为变量的逻辑回归模型中,晚期早产分娩与RANTES浓度相关(比值比[OR]=3.8)。在回归模型中对分娩方式变量进行调整后,RANTES浓度(OR=4.75)。

结论

晚期早产和剖宫产分娩都是脐带血中RANTES(CCL5)浓度低的重要危险因素。

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