Association of preterm birth with sustained postnatal inflammatory response.
OBJECTIVE
To investigate fetal or neonatal inflammatory patterns based on 25 inflammatory markers in neonatal dried blood spots samples from infants born preterm and term, collected several days after birth.


METHODS
Dried blood spots samples from 160 neonates were analyzed for 25 inflammatory markers using multiplex technology: 26 neonates born very preterm (before 32 weeks of gestation), drawn at a mean 6 days (95% confidence interval [CI], 5-7 days) after birth; 52 born preterm (32-36 weeks of gestation), drawn at mean 5 days (95% CI, 5-6 days) after birth; and 82 born at term (at or after 37 weeks of gestation), drawn at mean 5 days (95% CI, 5-5 days) after birth. Markers statistically significantly associated with preterm birth were analyzed in a multivariable model together with maternal and neonatal risk factors for preterm birth.


RESULTS
Elevated levels of interleukin (IL)-1beta, IL-6, soluble IL-6ralpha, IL-8, matrix metalloproteinase-9, and transforming growth factor-beta1 and decreased levels of IL-18, brain-derived neurotrophic factor, and C-reactive protein were associated with preterm birth. Maternal risk factors could explain only an increase of IL-1beta, whereas neonatal factors could explain several of the elevated and decreased inflammatory markers in the dried blood spots samples from the infants born preterm compared with the infants born at term.


CONCLUSIONS
The differences in levels of inflammatory markers in dried blood spots samples from infants born preterm compared with infants born at term supports the hypothesis that inflammation of fetal origin might be a cause of preterm birth.


METHODS
II.
Skogstrand
Kristin
K
Department of Clinical Biochemistry, Statens Serum Institut, Copenhagen, Denmark. ksk@ssi.dk
Hougaard
David M
DM
Schendel
Diana E
DE
Bent
Nørgaard-Pedersen
NP
Svaerke
Claus
C
Thorsen
Poul
P
D000328:Adult; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D053698:Interleukin-6 Receptor alpha Subunit / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D015999:Multivariate Analysis; D011247:Pregnancy; D047928:Premature Birth / Q000097:blood / Q000503:physiopathology*; D053773:Transforming Growth Factor beta1 / Q000097:blood
D019208:Brain-Derived Neurotrophic Factor; D016207:Cytokines; D053583:Interleukin-1beta; D015850:Interleukin-6; D053698:Interleukin-6 Receptor alpha Subunit; D016209:Interleukin-8; D053773:Transforming Growth Factor beta1; D002097:C-Reactive Protein; D020780:Matrix Metalloproteinase 9