title: Cord blood biomarkers of the fetal inflammatory response.
abstract: OBJECTIVE
  In current, neonatal practice, clinical signs of intrauterine infection (IUI) are often non-specific. From a large panel of immune biomarkers, we seek to identify cord blood markers that are most strongly associated with the fetal inflammatory response (FIR), a specific placental lesion associated with serious neonatal complications.
  
  
  METHODS
  We used multiplex immunoassay to measure 27 biomarkers, selected as part of an NIH-funded study of preterm birth, according to gestational age (GA) and extent of placental inflammation: involvement of chorion, amnion, decidua (maternal inflammatory response, MIR); extension to umbilical cord or chorionic plate (FIR). We used false-discovery rate (FDR < 5%, P < 0.001) to account for multiple comparisons.
  
  
  RESULTS
  Among 506 births (GA 23-42 weeks), IL-1 beta increased with FIR among preterm subgroups (P = 0.0001 for <32 weeks; P = 0.0009 for 33-36 weeks). IL-6 and IL-8 increased with FIR among preterm and full-term infants (P < 0.0001). P-trend for IL-6 and IL-8 with MIR versus FIR was <0.0001. Comparison with respect to clinical IUI yielded persistent elevation with FIR even when clinical signs were absent. The remaining 24 markers were not significantly associated.
  
  
  CONCLUSIONS
  We conclude that among 27 cord blood biomarkers, IL-1 beta, IL-6 and IL-8 are selectively associated with FIR. These markers may be clinically useful indicators of extensive IUI associated with poor neonatal outcome.
authors.affiliation: Division of Neonatology, Children's Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60614, USA. k-mestan@northwestern.edu
authors.forename: Karen
authors.initials: K
authors.lastname: Mestan
authors.forename: Yunxian
authors.initials: Y
authors.lastname: Yu
authors.forename: Poul
authors.initials: P
authors.lastname: Thorsen
authors.forename: Kristin
authors.initials: K
authors.lastname: Skogstrand
authors.forename: Nana
authors.initials: N
authors.lastname: Matoba
authors.forename: Xin
authors.initials: X
authors.lastname: Liu
authors.forename: Rajesh
authors.initials: R
authors.lastname: Kumar
authors.forename: David M
authors.initials: DM
authors.lastname: Hougaard
authors.forename: Munish
authors.initials: M
authors.lastname: Gupta
authors.forename: Colleen
authors.initials: C
authors.lastname: Pearson
authors.forename: Katherin
authors.initials: K
authors.lastname: Ortiz
authors.forename: Howard
authors.initials: H
authors.lastname: Bauchner
authors.forename: Xiaobin
authors.initials: X
authors.lastname: Wang
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000276:immunology / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism*; D005260:Female; D005312:Fetal Blood / Q000276:immunology / Q000378:metabolism*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007249:Inflammation / Q000196:embryology / Q000378:metabolism*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology / Q000378:metabolism; D014591:Uterine Diseases / Q000276:immunology / Q000378:metabolism; D055815:Young Adult
chemical_list: D015415:Biomarkers