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Cited by 368Neonatal Respiratory Health ResearchPreterm Birth and ChorioamnionitisNeonatal and Maternal Infections

A systemic fetal inflammatory response and the development of bronchopulmonary dysplasia

Yoon, Bo Hyun, Romero, Roberto, Kim, Kyung Sun, Park, Joong Shin, Ki, Suk Hyun, Kim, Beyong Il, Jun, Jong Kwan·1999·American Journal of Obstetrics and Gynecology
DOI 10.1016/s0002-9378(99)70299-1
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Abstract

Objective The purpose of this study was to test the hypothesis that a systemic fetal inflammatory response is a risk factor for the subsequent development of bronchopulmonary dysplasia in preterm neonates.Study design The relationship between interleukin 6 concentrations in umbilical cord plasma at birth and the occurrence of bronchopulmonary dysplasia was examined in 203 preterm births (25-34 weeks). Ninety-six patients underwent transabdominal amniocentesis within 5 days of birth. The relationship between umbilical cord plasma interleukin 6 concentration and bronchopulmonary dysplasia was compared with the relationship between amniotic fluid interleukin 6 concentration and bronchopulmonary dysplasia. Interleukin 6 was measured by specific immunoassay. Logistic regression was used for statistical analysis.Results Bronchopulmonary dysplasia was diagnosed in 17% (34/203) of the infants. Neonates in whom bronchopulmonary dysplasia developed had a significantly higher median interleukin 6 concentration in umbilical cord plasma at birth than did those in whom bronchopulmonary dysplasia did not develop (median, 68.3 pg/mL and range, 0.3-6150.0 pg/mL vs median, 6.9 pg/mL and range 0-19,230.0 pg/mL; P <.001). This difference remained significant after adjustment for gestational age at birth (odds ratio, 4.2; 95% confidence interval, 1.6-11.2). Logistic regression analysis indicated that an elevated umbilical cord plasma interleukin 6 concentration was a better predictor of the development of bronchopulmonary dysplasia than was an elevated amniotic fluid interleukin 6 concentration (P <.005).Conclusion An elevated interleukin 6 concentration in umbilical cord plasma at birth is an independent risk factor for the development of bronchopulmonary dysplasia. These data support the concept that the injury responsible for bronchopulmonary dysplasia in a subset of neonates may begin before birth and is associated with the development of a fetal systemic inflammatory response, as determined by plasma concentrations of interleukin 6.

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  • The fetal inflammatory response has been linked to the onset of preterm labour, fetal injury, and long-term handicap including periventricular leucomalacia, cerebral palsy, and chronic lung disease.

    “The fetal inflammatory response has been linked to the onset of preterm labour, and fetal injury and long-term handicap—including periventricular leucomalacia, cerebral palsy, and chronic lung disease.92, 93, 94”

    From Epidemiology and causes of preterm birth (2008) · cites this paper as [94]

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Authors
Yoon, B. H., Romero, R., Kim, K. S., Park, J. S., Ki, S. H., Kim, B. I., & Jun, J. K.
Affiliations
Seoul National University (KR)
ORCID
Venue
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
1999-10
Volume
181
Issue
4
Pages
773-779
ISSN
0002-9378 (ISSN-L)
DOI
10.1016/s0002-9378(99)70299-1
OpenAlex
W1994673004
Cited by
368
References
28
Citations by year
2026: 3 · 2025: 3 · 2024: 2 · 2023: 5 · 2022: 5 · 2021: 10 · 2020: 6 · 2019: 6 · 2018: 3 · 2017: 12 · 2016: 10 · 2015: 12 · 2014: 17 · 2013: 14 · 2012: 13
FWCI
13.41
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • American Journal of Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
  • Health Sciences › Medicine › Epidemiology › Preterm Birth and Chorioamnionitis
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
Keywords
bronchopulmonary dysplasia, interleukin-6, fetal inflammatory response, preterm infants, umbilical cord plasma, amniotic fluid, risk factors, systemic inflammation, transabdominal amniocentesis
MeSH terms
Adult, Amniocentesis, Amniotic Fluid, Bronchopulmonary Dysplasia, Female, Fetal Blood, Fetal Diseases, Gestational Age, Humans, Infant, Newborn, Infant, Premature, Inflammation, Pregnancy, Risk Factors, Interleukin-6

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