Kacerovsky Marian, Cobo Teresa, Andrys Ctirad, Musilova Ivana, Drahosova Marcela, Hornychova Helena, Janku Petr, Jacobsson Bo
Biomedical Research Center, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
J Matern Fetal Neonatal Med. 2013 May;26(8):795-801. doi: 10.3109/14767058.2013.765404. Epub 2013 Feb 1.
To evaluate the influence of microbial invasion of the amniotic cavity (MIAC) and histological chorioamnionitis (HCA) on the intensity of the fetal inflammatory response and the occurrence of fetal inflammatory response syndrome (FIRS) in preterm prelabor rupture of membranes (PPROM).
One hundred and forty-nine women with singleton pregnancies complicated by PPROM between the gestational ages 24 + 0 and 36 + 6 weeks were included in the study. Blood samples were obtained by venipuncture from the umbilical cord after the delivery of the newborn. The umbilical cord blood interleukin (IL)-6 levels were evaluated using ELISA kits. The fetal inflammatory response was determined by IL-6 levels, and FIRS was defined as an umbilical cord blood IL-6 >11 pg/mL.
IL-6 levels and the occurrence of FIRS were higher in women complicated with both MIAC and HCA (median IL-6 35.5 pg/mL, FIRS in 68%) than in women with HCA alone (median IL-6 5.8 pg/mL, FIRS in 36%), MIAC alone (median IL-6 2.8 pg/mL, FIRS in 17%) or women without MIAC or HCA (median IL-6 4.3 pg/mL, FIRS in 29%). There were no differences in IL-6 levels or rates of FIRS among women with MIAC alone or HCA alone and women without both MIAC and HCA.
A higher fetal inflammatory response mediated by umbilical cord blood IL-6 was identified when both MIAC and HCA were detected in pregnancies complicated by PPROM.
评估羊膜腔微生物入侵（MIAC）和组织学绒毛膜羊膜炎（HCA）对早产胎膜早破（PPROM）胎儿炎症反应强度及胎儿炎症反应综合征（FIRS）发生情况的影响。
本研究纳入149例单胎妊娠合并PPROM、孕周在24⁺⁰至36⁺⁶周之间的孕妇。新生儿出生后，经静脉穿刺采集脐带血样本。使用酶联免疫吸附测定试剂盒评估脐带血白细胞介素（IL）-6水平。根据IL-6水平确定胎儿炎症反应，FIRS定义为脐带血IL-6>11 pg/mL。
合并MIAC和HCA的孕妇（IL-6中位数为35.5 pg/mL，FIRS发生率为68%）的IL-6水平及FIRS发生率高于仅合并HCA的孕妇（IL-6中位数为5.8 pg/mL，FIRS发生率为36%）、仅合并MIAC的孕妇（IL-6中位数为2.8 pg/mL，FIRS发生率为17%）或未合并MIAC或HCA的孕妇（IL-6中位数为4.3 pg/mL，FIRS发生率为29%）。仅合并MIAC或仅合并HCA的孕妇与未合并MIAC和HCA的孕妇在IL-6水平或FIRS发生率上无差异。
在合并PPROM的妊娠中，当同时检测到MIAC和HCA时，可发现由脐带血IL-6介导的更高的胎儿炎症反应。
