ABSTRACT
OBJECTIVE: The main aim of this study was to determine the levels of cortisol and dehydroepiandrosterone sulfate (DHEA-S) and the cortisol/DHEA-S ratio in the umbilical cord blood according to the presence of histological chorioamnionitis and fetal inflammatory response in pregnancies complicated by prelabor rupture of membranes at fewer than 34 gestational weeks. METHODS: Seventy-two women with singleton pregnancies complicated by preterm prelabor rupture of membranes between gestational ages 24+0 and 33+6 weeks were included in the study. The sample of blood was obtained from the umbilical cord after delivery of the newborn. The umbilical cord blood cortisol and DHEA-S levels were evaluated using commercial immunoassay kits. A cortisol/DHEA-S ratio was calculated. RESULTS: The presence of histological chorioamnionitis was not associated with higher median levels of cortisol (32.1 nmol/L vs. 33.0 nmol/L; p = 0.53), DHEA-S (2.6 µmol/L vs. 2.5 µmol/L; p = 0.83), or cortisol/DHEA-S ratio (19.5 vs. 18.7;p = 0.90). Higher median levels of DHEA-S (3.1 µmol/L vs. 2.3 µmol/L; p = 0.03) but not cortisol (91.0 nmol/L vs. 32.0 nmol/L; p = 0.06) or cortisol/DHEA-S ratio (24.5 vs. 18.7; p = 0.46) were observed when fetal inflammatory response was present. CONCLUSIONS: The presence of fetal inflammatory response but not the presence of histological chorioamnionitis per se was associated with increased DHEA-S levels in the umbilical cord blood.
Subject(s)
Chorioamnionitis/blood , Dehydroepiandrosterone Sulfate/blood , Fetal Blood/metabolism , Hydrocortisone/blood , Inflammation/blood , Adult , Biomarkers/blood , Chorioamnionitis/pathology , Female , Fetal Membranes, Premature Rupture/blood , Gestational Age , Humans , Infant, Newborn , Inflammation/etiology , Linear Models , Pregnancy , Prospective StudiesABSTRACT
OBJECTIVE: To determine whether umbilical cord blood concentrations of soluble scavenger receptor for hemoglobin (sCD163) and pentraxin 3 (PTX3) are of value in the early postpartum diagnosis of histological chorioamnionitis in preterm prelabor rupture of membranes (PPROM). METHODS: Eighty-three women with pregnancies complicated by PPROM between 24 and 36 weeks of gestation with (n = 38) and without (n = 45) the presence of histological chorioamnionitis were included in the study. We compared umbilical cord blood sCD163 and PTX3 levels in preterm neonates from PPROM pregnancies with versus without the presence of histological chorioamnionitis using nonparametric test (Mann-Whitney U test). RESULTS: The presence of histological chorioamnionitis was associated with a higher median umbilical cord blood sCD163, but not PTX3 concentration, to compare with the absence of histological chorioamnionitis [sCD163: median 1466 ng/mL, interquartile range (IQR) 1187-1828 vs. 1168 ng/mL, IQR 887-1595; p = 0.01; PTX3: median 3.96 ng/mL, IQR 2.24-6.77 vs. 2.95 ng/mL, IQR 1.74-6.93; p = 0.49]. CONCLUSIONS: HCA is associated with an increase of umbilical cord blood sCD163, but not PTX3 concentration. Umbilical cord blood sCD163 seems to be a postpartum marker of the presence of histological chorioamnionitis.
Subject(s)
Antigens, CD/blood , Antigens, Differentiation, Myelomonocytic/blood , C-Reactive Protein/metabolism , Chorioamnionitis/blood , Receptors, Cell Surface/blood , Serum Amyloid P-Component/metabolism , Adult , Biomarkers/blood , Chorioamnionitis/diagnosis , Female , Fetal Blood/metabolism , Humans , Infant, Newborn , Infant, Premature , Postpartum Period , Pregnancy , Prospective StudiesABSTRACT
OBJECTIVE: To determine whether umbilical cord blood concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8), and matrix metalloproteinase-8 (MMP-8) are of value in the diagnosis of histological chorioamnionitis (HCA) and funisitis in patients with preterm premature rupture of membranes (PPROM). SETTING: Department of Obstetrics and Gynaecology, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Czech Republic. METHODS: We compared umbilical cord blood IL-6, IL-8, and MMP-8 concentrations in 83 women with PPROM between 24th and 36th gestational weeks with the presence and the absence of HCA/funisitis using nonparametric tests (Mann-Whitney U test), given the non-normal distribution of analyte. Comparisons of proportions were performed the D'Agostino and Pearson omnibus normality test and the Shapiro-Wilk test. RESULTS: Patients with HCA had a significantly higher median umbilical cord blood IL-6 concentration than patients without histological signs of inflammation (12.0 pg/mL [2.1-138.3] versus 2.7 pg/mL [0.1-12.4]; p=0.004) but did not have significantly higher median umbilical cord IL-8 (29.9 pg/mL [14.0-186.3]; versus 18.9 pg/mL [7.9-89.4]; p=0.13) and MMP-8 (2.9 pg/mL [0.5-25.2] versus 0.5 ng/mL [0.5-7.9]; p=0.18). Patients with HCA and funisitis had a significantly higher median umbilical cord blood IL-6 (222 pg/mL [95.3-411.7] versus 6.1 pg/mL [1.3-18.5]; p<0.0001) and IL-8 (20.9 pg/mL [8.4-37.7] versus 190.7 pg/mL [83.8-554.2]; p=0.0004) concentration than patients with HCA alone. Differences were not found in MMP-8 concentrations (3.7 ng/mL [0.5-21.4] versus 2.4 ng/mL [0.5-88.1]; p=0.7). CONCLUSION: HCA was associated with a significant increase in umbilical cord blood IL-6 concentration. In patients with HCA and funisitis, umbilical cord blood IL-6 and IL-8 were significantly higher than those without histological signs of inflammation.
