Correlation of markers of maternal and fetal inflammation
DOI:
https://doi.org/10.15574/HW.2024.172.55Keywords:
pregnant women, newborns, fetal inflammatory response syndrome, C-reactive protein, procalcitonin, interleukins, secretory inhibitor of leukocyte proteinase, amniotic fluid glucoseAbstract
Fetal inflammatory response syndrome (IFRS) is an inadequate reaction of the fetal immune system to the inflammatory process in the placenta, which is accompanied by an increase in neonatal mortality and morbidity.
Aim - to assess the dependence of IFRS on the markers of the inflammatory process of the mother in premature births in different gestational periods to determine the date of delivery.
Materials and methods. 405 mothers with premature singleton deliveries and their premature newborns were examined. The Spearman correlation method was used to calculate the relationship between IL-6 content in the umbilical cord blood of a newborn and laboratory markers of maternal inflammation in peripheral blood (containing leukocytes and rod-shaped neutrophils, C-reactive protein, procalcitonin, pro-inflammatory interleukins), amniotic fluid (glucose, secretory inhibitor of leukocyte proteinase (SILP) and pro-inflammatory interleukins) and cervical mucus (pro-inflammatory interleukins).
Results. Between the indicators of the mother's peripheral blood circulation and the value of IL-6, only a moderate connection was found, and the content of IL-6 in the amniotic fluid shows a strong correlation with the concentration of IL-6 in the umbilical cord blood of extremely premature newborns. For SILP, a strong correlation with the laboratory marker SFZV was found. A negative correlation with IL-6 of umbilical cord blood was found in cervical mucus for SILP. Signs of infection in the newborn show a strong dependence on the concentration of C-reactive protein and procalcitonin in the peripheral blood of the mother, but this was not found for extremely premature newborns. A strong correlation was found between the concentration of glucose in the amniotic fluid and signs of infection in premature infants in both gestational categories.
Conclusions. Among indicators of peripheral blood circulation of a pregnant woman, none shows a strong correlation with IFRS. The concentration of SILP in the amniotic fluid has a strong correlation with signs of fetal inflammation, regardless of gestational age. The content of SILP in the cervical mucus has a strong negative correlation with the criterion of IFRS in preterm infants against the background of intact fetal membranes. A strong correlation between the glucose content in the amniotic fluid and signs of infection in the premature infant was revealed. For extremely premature newborns, no indicator of the mother's peripheral blood correlates with signs of infection.
The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the women was obtained for the research.
The authors declare no conflict of interest.
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