title: The importance of intra-amniotic inflammation in the subsequent development of atypical chronic lung disease.
abstract: OBJECTIVE
  To examine whether the intra-amniotic inflammation is a risk factor for the development of atypical chronic lung disease (CLD).
  
  
  METHODS
  A retrospective cohort study was undertaken in 72 patients who delivered preterm neonates (gestational age: 24-32 weeks) within 5 days of amniocentesis and whose neonates subsequently developed CLD. Atypical CLD was defined as CLD without respiratory distress syndrome (RDS). Intra-amniotic inflammation was defined as an elevated amniotic fluid (AF) concentration of matrix metalloproteinase-8 (MMP-8) (>23 ng/ml).
  
  
  RESULTS
  (1) Atypical CLD was identified in 54.2% (39/72) of cases with CLD; (2) there were no significant differences in the median gestational age at birth and the rate of antenatal corticosteroid use between infants with atypical CLD and CLD with RDS; (3) preterm newborns with atypical CLD had a significantly higher median AF MMP-8 concentration (median 373.1 ng/ml vs. 8.6 ng/ml, p = 0.003) and median AF white blood cell count (median 450.0/mm(3)vs. 5.5/mm(3), p = 0.009), and a higher rate of intra-amniotic inflammation (74.4%vs. 45.5%, p = 0.012) than those with CLD with RDS.
  
  
  CONCLUSIONS
  Intra-amniotic inflammation confers a greater risk for atypical CLD than for typical CLD with initial RDS. This novel observation strengthens the importance of prenatal inflammation as a mechanism of lung injury.
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 110-744, Korea.
authors.forename: Joonho
authors.initials: J
authors.lastname: Lee
authors.forename: Kyung Joon
authors.initials: KJ
authors.lastname: Oh
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Yang
authors.forename: Joong Shin
authors.initials: JS
authors.lastname: Park
authors.forename: Roberto
authors.initials: R
authors.lastname: Romero
authors.forename: Bo Hyun
authors.initials: BH
authors.lastname: Yoon
mesh_terms: D000328:Adult; D002821:Chorioamnionitis / Q000453:epidemiology; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000209:etiology; D007249:Inflammation / Q000150:complications / Q000453:epidemiology; D008171:Lung Diseases / Q000151:congenital* / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D047928:Premature Birth / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D055815:Young Adult