Histologic chorioamnionitis and umbilical serum levels of pro-inflammatory cytokines and cytokine inhibitors.
OBJECTIVE
To study 1. whether leucocyte infiltration in placenta tissues is associated with elevated umbilical serum levels of inflammatory mediators, and 2. whether leucocyte infiltration in the presence of neonatal disease is associated with additional increase in mediator levels.


METHODS
University hospital.


METHODS
Two groups of women with either normal delivery (n = 82) or delivery complicated by prolonged rupture of the membranes, clinical signs of intrauterine infection or preterm labour (n = 139).


METHODS
Umbilical cord blood and placenta tissues were collected after delivery. Placentas were classified as non-inflamed (i.e. without leucocyte infiltration, n = 74), or as mild (n = 84), or severe chorioamnionitis (n = 63). Mediator levels were compared between groups.


RESULTS
Severe chorioamnionitis was associated with elevated levels of tumour necrosis factor (TNF)alpha, interleukin (IL)-1beta, IL-6, IL-8, soluble TNF receptor p55 and p75, IL-1 receptor antagonist (IL-IRA), and C-reactive protein compared with non-inflamed placentas (all P < 0.05). No differences were found between mild chorioamnionitis and placentas without infiltration. In all, 49 babies suffered from various perinatal diseases, such as clinical sepsis, respiratory distress and asphyxia, and 172 were healthy. Severe chorioamnionitis with subsequent neonatal disease (n = 23) had higher levels of all mediators, except IL-1beta and C-reactive protein, than severe chorioamnionitis without neonatal disease (n = 40, all P < 0.01), but severe chorioamnionitis was also accompanied by a more intense and widely distributed leucocyte infiltration when neonatal disease developed.


CONCLUSIONS
High grade leucocyte infiltration in placenta tissues is associated with elevated levels of TNFalpha, IL-1beta, IL-6, IL-8, p55, p75, IL-IRA and C-reactive protein in umbilical serum. The presence of neonatal disease is associated with advanced chorioamnionitis, and highly elevated levels of both pro- and antiinflammatory mediators in umbilical serum.
Døllner
Henrik
H
Institute of Cancer Research and Molecular Biology, Norwegian University of Science and Technology, Trondheim.
Vatten
Lars
L
Halgunset
Jostein
J
Rahimipoor
Shahnaz
S
Austgulen
Rigmor
R
D000208:Acute Disease; D000704:Analysis of Variance; D002821:Chorioamnionitis / Q000097:blood*; D016207:Cytokines / Q000037:antagonists & inhibitors / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000276:immunology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007962:Leukocytes / Q000276:immunology*; D007752:Obstetric Labor, Premature / Q000150:complications / Q000276:immunology; D010920:Placenta / Q000276:immunology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology; D014469:Umbilical Arteries
D016207:Cytokines