Intraamniotic inflammation and umbilical cord blood interleukin-6 concentrations in pregnancies complicated by preterm prelabor rupture of membranes

Musilová, Ivana; Andrýs, Ctirad; Drahosova, Marcela; Souček, Ondřej; Štěpán, Martin; Bestvina, Tomas; Špaček, Richard; Jacobsson, Bo; Cobo, Teresa; Kacerovský, Marian

doi:10.1080/14767058.2016.1197900

Cited by 20 publications

(17 citation statements)

References 40 publications

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“…FIRS defined as having umbilical cord blood IL-6 concentrations greater than 11 pg/ml was found to be correlated with a higher rate of early-onset sepsis. This finding is in line with the results from other studies as well as our own performed in women with PPROM (8,10,29). However, when FIRS was determined based on the histopathology of the placenta, the present study revealed higher rates of intraventricular hemorrhage grades I and II, but not of early-onset sepsis.…”

Section: Discussionsupporting

confidence: 93%

“…Lee et al described a stronger intensity of the fetal inflammatory response, measured by C-reactive protein levels, when both MIAC and IAI were present (28). Conversely, our group has not identified any difference in the intensity of the fetal inflammatory response based on IL-6 levels (29). The occurrence of IAI alone in PPROM between 34 and 37 weeks of gestation was relatively infrequent.…”

Section: Discussioncontrasting

confidence: 57%

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Late preterm prelabor rupture of fetal membranes: fetal inflammatory response and neonatal outcome

et al. 2017

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BackgroundTo characterize the influence of microbial invasion of the amniotic cavity (MIAC) and/or intra-amniotic inflammation (IAI) on the intensity of the fetal inflammatory response and the association between the presence of the fetal inflammatory response syndrome (FIRS) and short-term neonatal morbidity in the preterm prelabor rupture of membranes (PPROM) between the gestational ages of 34 and 37 weeks.MethodsOne hundred and fifty-nine women were included in the study. The umbilical cord blood interleukin (IL)-6 concentrations were determined using enzyme-linked immunosorbent assay kits. FIRS was defined based on the umbilical cord blood IL-6 concentration and the presence of funisitis and/or chorionic plate vasculitis.ResultsWomen with both MIAC and IAI had the highest median umbilical cord blood IL-6 concentrations and highest rates of FIRS. Women with FIRS had the higher rates of early-onset sepsis and intraventricular hemorrhage grades I and II when FIRS was characterized based on the umbilical cord blood IL-6 concentrations and the histopathological findings.ConclusionThe presence of both MIAC and IAI was associated with a higher fetal inflammatory response and a higher rate of FIRS. Different aspects of short-term neonatal morbidity were related to FIRS when defined by umbilical cord blood IL-6 concentrations and the histopathology of the placenta.

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Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 57%

Late preterm prelabor rupture of fetal membranes: fetal inflammatory response and neonatal outcome

et al. 2017

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“…Additionally, the highest levels of cell‐free nDNA were detected in women with PPROM, where the presence of bacteria in the amniotic fluid led to the development of IAI (microbial‐associated IAI). This specific subgroup of PPROM is known to be associated with the highest maternal, intra‐amniotic, and fetal inflammatory response . We hypothesized that intra‐amniotic inflammation driven by the amniotic fluid bacteria induces necrosis and apoptosis of fetal membranes and the placenta, followed by more intense cell‐free nDNA release from these tissues .…”

Section: Discussionmentioning

confidence: 99%

“…This specific subgroup of PPROM is known to be associated with the highest maternal, intra-amniotic, and fetal inflammatory response. 4,42,43 We hypothesized that intraamniotic inflammation driven by the amniotic fluid bacteria induces An association between cell-free nDNA and IL-6 levels in systemic circulation was previously identified when serious inflammatory conditions were present. 47,48 Interestingly, such a relationship between cell-free nDNA and IL-6 levels in the blood are revealed in women with labor at the time of delivery.…”

Section: Amniotic Fluid Supernatant Levels Of Cell-free Mtdna Accormentioning

confidence: 99%

Amniotic fluid cell‐free DNA in preterm prelabor rupture of membranes

et al. 2018

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Introduction We evaluated the levels of cell‐free nuclear DNA (nDNA) and cell‐free mitochondrial DNA (mtDNA) in the amniotic fluid supernatant from pregnancies complicated by preterm prelabor rupture of membranes (PPROM) based on evidence of microbial invasion of the amniotic cavity (MIAC) and/or intra‐amniotic inflammation (IAI). Material and methods A total of 155 women with PPROM were included in this study. Amniotic fluid samples were obtained by transabdominal amniocentesis. The levels of cell‐free nDNA and mtDNA in the amniotic fluid supernatant were assessed and quantified by real‐time polymerase chain reaction. Results The levels of cell‐free nDNA and mtDNA were higher in women with MIAC and IAI than in women without these conditions (nDNA: with MIAC: median 3.9 × 104 genome equivalent [GE]/mL vs without MIAC: median 1.2 × 104 GE/mL, with IAI: median: 5.3 × 104 GE/mL vs without IAI: median 1.2 × 104 GE/mL; mtDNA: with MIAC: median 9.2 × 105 GE/mL vs without MIAC: median 2.5 × 105 GE/mL, with IAI: median 1.1 × 106 GE/mL vs without IAI: median 2.5 × 105; all P values ≤ 0.01). Women with the microbial‐associated IAI showed the highest levels of cell‐free nDNA and mtDNA. Conclusions Cell‐free nDNA and mtDNA are constituents of the amniotic fluid supernatant from PPROM pregnancies. Both cell‐free nDNA and mtDNA are involved in the intra‐amniotic inflammatory response in women with PPROM.

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“…The proposed routes of microbial access to the placenta and amniotic cavity in adverse pregnancy outcomes are the same as those reported for healthy pregnancies. The genital mycoplasmas and Streptococcus agalactiae are frequently isolated bacteria in cases of preterm pre-labor rupture of membranes [59]. However, bacteria isolated from the amniotic cavity are not always recovered from the vagina suggesting an alternate route for microbial translocation [40].…”

Section: Where Do Placental Microorganisms and Microbial Products In mentioning

confidence: 99%

Review: Maternal health and the placental microbiome

et al. 2017

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Over the past decade, the role of the microbiome in regulating metabolism, immune function and behavior in humans has become apparent. It has become clear that the placenta is not a sterile organ, but rather has its own endogenous microbiome. The composition of the placental microbiome is distinct from that of the vagina and has been reported to resemble the oral microbiome. Compared to the gut microbiome, the placental microbiome exhibits limited microbial diversity. This review will focus on the current understanding of the placental microbiota in normal healthy pregnancy and also in disease states including preterm birth, chorioamnionitis and maternal conditions such as obesity, gestational diabetes mellitus and preeclampsia. Factors known to alter the composition of the placental microbiota will be discussed in the final part of this review.

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Intraamniotic inflammation and umbilical cord blood interleukin-6 concentrations in pregnancies complicated by preterm prelabor rupture of membranes

Abstract: IAI was associated with the highest umbilical cord blood IL-6 concentrations and rate of FIRS independent of the presence or absence of MIAC.

Cited by 20 publications

References 40 publications

Late preterm prelabor rupture of fetal membranes: fetal inflammatory response and neonatal outcome

Late preterm prelabor rupture of fetal membranes: fetal inflammatory response and neonatal outcome

Amniotic fluid cell‐free DNA in preterm prelabor rupture of membranes

Review: Maternal health and the placental microbiome

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