The relationship among inflammatory lesions of the umbilical cord (funisitis), umbilical cord plasma interleukin 6 concentration, amniotic fluid infection, and neonatal sepsis

Yoon, Bo Hyun; Romero, Roberto; Park, Joong Shin; Kim, Miha; Oh, Soo‐Young; Kim, Chong Jai; Jun, Jong Kwan

doi:10.1067/mob.2000.109035

Cited by 406 publications

(297 citation statements)

References 18 publications

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“…A IL-6 é considerada a principal citocina envolvida no desenvolvimento da síndrome da resposta inflamatória fetal, definida inclusive pelo nível sérico da citocina e associada à corioamnionite e funisite 27,28 .…”

Section: Discussionunclassified

Antenatal maternal corticosteroid administration and markers of oxidative stress and inflammation in umbilical cord blood from very low birth weight preterm newborn infants

et al. 2012

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Objective: To investigate the association between antenatal maternal corticosteroid administration and blood levels of reactive oxygen intermediates (ROI), reduced glutathione (GR) and interleukin-6 (IL-6) in preterm, very low birth weight infants. Methods:This was a cohort study in which cord blood samples were used for the following tests: baseline and stimulated granulocyte ROI were measured by flow cytometry; GR was assayed by spectrophotometry; and IL-6 by enzyme-linked immunosorbent assay. Two different comparative analyses of antenatal corticosteroid (betamethasone) were conducted: the first compared administration against no administration and the second compared mothers who received the complete cycle with those given only a partial antenatal corticosteroid cycle. Maternal and neonatal variables were analyzed in order to compare groups. Categorical variables were compared using the chi-square or Fischer tests, and blood marker test results were compared using the Mann-Whitney test. Results:The different corticoid therapy groups were similar in terms of all of the maternal and neonatal variables with the exception of vaginal delivery, which was significantly associated with not receiving antenatal corticosteroid. The results for ROI, GR and IL-6 did not differ when the comparison was based on simple presence or absence of administration of the steroid. However, when the complete cycle was compared against incomplete administration, median ROI and IL-6 were lower among those given the complete cycle. Conclusion:Administration of the complete cycle of betamethasone to the mother had a suppressive effect on baseline ROI and IL-6 production in very low birth weight preterm newborn infants.J Pediatr (Rio J). 2012;88(1):61-6: Newborn, oxidative stress, reactive oxygen species, interleukin-6, glutathione. ResumoObjetivo: Avaliar a associação entre o uso materno antenatal de corticosteroide e os níveis sanguíneos de intermediários reativos de oxigênio (ROI), glutationa reduzida (GR) e interleucina-6 (IL-6) em recém-nascidos pré-termo de muito baixo peso ao nascer.Métodos: Estudo de coorte. A dosagem foi feita em sangue de cordão umbilical. A dosagem de ROI por granulócitos foi realizada por citometria de fluxo nos estados basal e estimulado; a GR, por espectrofotometria; e a IL-6, por enzyme-linked immunosorbent assay. Foram considerados dois grupos em relação ao uso de corticosteroide (betametasona) antenatal: uso ou não da medicação; e, se presente, se foi de modo completo ou parcial. Variáveis maternas e neonatais foram consideradas para efeito de comparação dos grupos. As variáveis categóricas foram comparadas usando os testes do qui-quadrado ou de Fischer, e as comparações dos valores dos marcadores sanguíneos foram feitas usando-se o teste de Mann-Whitney.Resultados: Os grupos de corticoterapia foram comparáveis em relação às variáveis maternas e neonatais, exceto a ocorrência de parto vaginal, o qual foi associado significativamente à ausência de uso de corticosteroide antenatal. Os valores de ROI...

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Section: Discussionunclassified

Antenatal maternal corticosteroid administration and markers of oxidative stress and inflammation in umbilical cord blood from very low birth weight preterm newborn infants

et al. 2012

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“…Diversos estudos, experimentais e clínicos, demonstraram o envolvimento da infecção intra-uterina com a maior ocorrência de LPV [11][12][13] …”

Section: Introductionunclassified

Periventricular leukomalacia in very low birth weight preterm neonates with high risk for neonatal sepsis

Silveira

Procianoy

Dill³

et al. 2008

J Pediatr (Rio J)

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ResumoObjetivo: Verificar a associação de leucomalácia periventricular (LPV) e sepse neonatal em recém-nascidos de muito baixo peso (RNMBP). Métodos AbstractObjective: To investigate the association between periventricular leukomalacia (PVL) and neonatal sepsis in very low birth weight infants (VLBWI). Methods:We studied VLBWI with a clinical suspicion of infection who had been born at our institution between the 1st of August, 2005 and the 31st of July, 2007. Children were excluded if they died before reaching 14 days, had malformations of the central nervous system or congenital infections. Ultrasound brain scans were carried out on the third day and weekly up until the sixth week of life or discharge. Periventricular leukomalacia was diagnosed by persistent diffuse periventricular hyperechogenecity for more than 7 days, or by periventricular cysts. The VLBWI were separated into two groups on the basis of the presence or absence of PVL. Sepsis was defined as clinical manifestation plus a positive culture. The Mann-Whitney, chi-square and t tests were applied followed by logistic regression.Results: A total of 88 VLBWI were studied. Of these, 62 (70.5%) survived and 51 (57.8%) had PVL. Both groups were similar in terms of birth weight, gestational age, Apgar score, type of delivery, SNAPPE-II score, presence of necrotizing enterocolitis, persistent ductus arteriosus and deaths. Sepsis and mechanical ventilation were more common in the group with PVL (23.5 and 2.7%, p = 0.005; 86 and 59%, p = 0.004, respectively). Both of these were identified as, independent risk factors for PVL by logistic regression (p = 0.027 and 0.015, respectively). Conclusions:Chorioamnionitis has been defined as a risk factor for PVL. We have demonstrated that neonatal sepsis is also an important risk factor. We believe that the systemic inflammatory response is the principal factor involved in the etiopathogenesis of PVL among VLBWI.J Pediatr (Rio J). 2008;84(3):211-216

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“…18 Elevation of inflammatory mediators will probably occur in the early course of disease. 10,19 We studied neonates with gestational age equal to or higher than 34 weeks that presented early-onset sepsis defined by clinical manifestation and/or positive blood culture in the first 96 hours of life. Septic neonates were divided into two groups using the whole group median IL-6 level as the cutoff point.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8][9] Recent studies reported high IL-6 levels in umbilical cord blood in newborns with early-onset sepsis whose mothers had chorioamnionitis. 10,11 However, even though some newborn infants presented neonatal infection, they had low plasma IL-6 levels. 12 The aim of this study is to assess different perinatal findings and sample collection timing in newborns with early-onset sepsis comparing those with low IL-6 levels to the ones with high levels.…”

Section: Introductionmentioning

confidence: 99%

A influência do tempo de coleta sobre os níveis de interleucina-6 na sepse neonatal precoce

Procianoy¹,

Silveira²

2004

J. Pediatr. (Rio J.)

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Objective: To assess different perinatal findings and sample collection timing in newborns with early-onset sepsis comparing those with low IL-6 levels to the ones with high levels.Methods: Eighty-five newborn infants, with clinical signs of sepsis and/or positive blood cultures, had plasma IL-6 collected in the initial evaluation for early-onset sepsis in the first 96 hours of life. They were classified in two groups according to their plasma IL-6 levels: higher, and equal to or lower than IL-6 median value for the whole septic groupResults: Median IL-6 for the whole group was 89 pg/ml. High and low level groups were formed by 42 and 43 newborns respectively. There were no differences between the two groups regarding gestational ages, birth weights, cesarean-section proportion, Apgar scores, number of neonates with maternal risk factors for infection, number of maternal intrapartum antibiotic therapy, and number of positive blood cultures. Median plasma IL-6 in the high level group was 287 pg/ml, and in the low level group 46 pg/ml (p < 0.001). Median sample timing was 17.5 hours of life for the high level group and 36 hours of life for the low level group (p < 0.001). There was a significant negative correlation coefficient between IL-6 levels and sample collection timing. Conclusion:Sample collection timing is an important factor for detection of high plasma IL-6 level in newborn infants with earlyonset sepsis. ResumoObjetivo: Avaliar os diferentes achados perinatais e o tempo da coleta da amostra em recém-nascidos com sepse neonatal precoce, comparando os recém-nascidos com nível baixo e alto de IL-6.Métodos: Oitenta e cinco recém-nascidos com sinais clínicos de sepse e/ou hemoculturas positivas tiveram plasma coletado na avaliação inicial da sepse neonatal precoce nas primeiras 96 horas de vida. Foram divididos em: a) acima (grupo de nível elevado) e b) igual ou abaixo (grupo de nível baixo) da mediana da IL-6 do grupo total.Resultados: A mediana da IL-6 para o grupo total foi de 89 pg/ml. Os grupos de nível elevado e de nível baixo foram constituídos por 42 e 43 recém-nascidos, respectivamente. Não houve diferença significativa entre ambos os grupos quanto a idade gestacional, peso de nascimento, proporção de parto cesariano, escores de Apgar, número de recém-nascidos cujas mães tiveram fator de risco para infecção, número de mães que receberam antibiótico intraparto e número de hemoculturas positivas. A mediana da IL-6 plasmática do grupo de nível elevado foi 287 pg/ml, e do grupo de nível baixo foi 46 pg/ml (p < 0,001). A mediana do tempo de coleta foi 17,5 horas de vida no grupo de nível elevado e 36 horas de vida no grupo de nível baixo (p < 0,001). Houve uma significante correlação negativa entre níveis de IL-6 e tempo de coleta da amostra.Conclusão: O tempo de coleta da amostra é um fator importante para a detecção de níveis elevados de IL-6 em recém-nascidos com sepse neonatal precoce. The role of sample collection timing on interleukin-6 levels in early-onset neonatal sepsis A influência d...

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The relationship among inflammatory lesions of the umbilical cord (funisitis), umbilical cord plasma interleukin 6 concentration, amniotic fluid infection, and neonatal sepsis

Cited by 406 publications

References 18 publications

Antenatal maternal corticosteroid administration and markers of oxidative stress and inflammation in umbilical cord blood from very low birth weight preterm newborn infants

Antenatal maternal corticosteroid administration and markers of oxidative stress and inflammation in umbilical cord blood from very low birth weight preterm newborn infants

Periventricular leukomalacia in very low birth weight preterm neonates with high risk for neonatal sepsis

A influência do tempo de coleta sobre os níveis de interleucina-6 na sepse neonatal precoce

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