Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Republic of Korea.
Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, Republic of Korea.
Medicine (Baltimore). 2022 Jul 8;101(27):e29368. doi: 10.1097/MD.0000000000029368.
Prenatal and perinatal infections and inflammation appear to associated with the development of retinopathy of prematurity (ROP). In this study, we evaluated whether inflammatory mediators in amniotic fluid (AF) retrieved during cesarean delivery influence the development of ROP in very low birth weight (VLBW) infants. This retrospective study included 16 and 32 VLBW infants who did and did not develop any stage of ROP, respectively. Each infant with ROP was matched with 2 infants without ROP based on days of ventilation care, gestational age, and birth weight. AF was obtained during cesarean delivery, and the levels of intra-amniotic inflammatory mediators such as interleukin (IL)-1β, IL-2, IL-6, IL-8, IL-10, matrix metalloproteinase (MMP)-2, MMP-8, MMP-9, and tumor necrosis factor (TNF)-α were measured using a Human Magnetic Luminex assay (R&D Systems, Minneapolis, MN). The differences in the levels of inflammatory mediators according to the presence or absence of ROP were compared. In patients who developed ROP, the level of MMP-2 in the AF was significantly increased (P = .011), whereas the levels of IL-10 and TNF-α were significantly decreased (P = .028 and .046, respectively) compared with those in infants who did not develop ROP. The levels of the other mediators were not significantly different between the 2 groups. Multivariate regression analysis showed that MMP-2 was a risk factor for the development of ROP (odds ratio, 2.445; 95% confidence interval, 1.170-5.106; P = .017). The concentration of MMP-2 in AF is an independent factor in the development of ROP. Further studies are needed to determine whether the levels of inflammatory mediators in AF affect the ROP severity.
产前和围产期感染和炎症似乎与早产儿视网膜病变（ROP）的发生有关。在这项研究中，我们评估了剖宫产时从羊水中提取的炎症介质是否会影响极低出生体重（VLBW）婴儿 ROP 的发生。这项回顾性研究纳入了分别患有和未患有任何 ROP 分期的 16 名和 32 名 VLBW 婴儿。每个患有 ROP 的婴儿均根据通气治疗天数、胎龄和出生体重与 2 名无 ROP 的婴儿相匹配。在剖宫产时获得羊水，并使用人磁珠酶联免疫吸附试验（R&D 系统，明尼苏达州明尼阿波利斯）测量羊水中的宫内炎症介质（如白细胞介素（IL）-1β、IL-2、IL-6、IL-8、IL-10、基质金属蛋白酶（MMP）-2、MMP-8、MMP-9 和肿瘤坏死因子（TNF）-α）的水平。比较有无 ROP 时炎症介质水平的差异。在发生 ROP 的患者中，AF 中的 MMP-2 水平明显升高（P =.011），而 IL-10 和 TNF-α水平明显降低（P =.028 和.046）与未发生 ROP 的婴儿相比。两组间其他介质的水平无显著差异。多变量回归分析显示 MMP-2 是 ROP 发生的危险因素（优势比，2.445；95%置信区间，1.170-5.106；P =.017）。AF 中 MMP-2 的浓度是 ROP 发生的独立因素。需要进一步的研究来确定 AF 中炎症介质的水平是否会影响 ROP 的严重程度。
