title: Amniotic fluid tumor necrosis factor-alpha and the risk of respiratory distress syndrome among preterm infants.
abstract: OBJECTIVE
  We examined the effect of exposure to amniotic fluid infection and cytokines on the pulmonary outcome of preterm infants.
  
  
  METHODS
  A cohort of 136 preterm infants born to women in preterm labor had amniotic fluid cultures and tumor necrosis factor-alpha assays performed. Amniotic fluid was collected by transabdominal amniocentesis. Outcome measures included respiratory distress syndrome and length of oxygen and ventilator support. Logistic regression and Cox proportional hazards regression adjusted for birth weight and other confounders.
  
  
  RESULTS
  Respiratory distress syndrome developed in 67 (49%) of 136 infants. Elevated amniotic fluid tumor necrosis factor-alpha levels and amniotic fluid infection were significantly associated with respiratory distress syndrome. This association persisted after adjustment for birth weight. Infants exposed to tumor necrosis factor-alpha remained on supplemental oxygen and assisted ventilation longer and had longer hospital stays compared with nonexposed infants.
  
  
  CONCLUSIONS
  Prenatal exposure to tumor necrosis factor-alpha may be a risk factor for respiratory distress syndrome and its complications.
authors.affiliation: Department of Obstetrics and Gynecology, University of Washington, Seattle, USA.
authors.forename: J
authors.initials: J
authors.lastname: Hitti
authors.forename: M A
authors.initials: MA
authors.lastname: Krohn
authors.forename: D L
authors.initials: DL
authors.lastname: Patton
authors.forename: P
authors.initials: P
authors.lastname: Tarczy-Hornoch
authors.forename: S L
authors.initials: SL
authors.lastname: Hillier
authors.forename: E M
authors.initials: EM
authors.lastname: Cassen
authors.forename: D A
authors.initials: DA
authors.lastname: Eschenbach
mesh_terms: D000649:Amniocentesis; D000653:Amniotic Fluid / Q000737:chemistry* / Q000382:microbiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D007902:Length of Stay; D011247:Pregnancy; D011446:Prospective Studies; D012044:Regression Analysis; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis* / Q000378:metabolism
chemical_list: D014409:Tumor Necrosis Factor-alpha