Increased cord serum inflammatory markers in small-for-gestational-age neonates.
OBJECTIVE
The pathological picture in ischemic tissue injury shares features with the inflammatory response. Hypoxia-mediated induction of interleukin-6 (IL-6) could set in motion the mechanisms limiting inflammation in ischemia. Intrauterine growth restriction (IUGR) represents a human model of chronic fetal hypoxia. The purpose of this study was a first-time exploration to determine whether cord blood obtained at the delivery of small-for-gestational-age (SGA) infants has increased concentrations of inflammatory markers.


METHODS
Cord blood was collected from 20 SGA (term and near-term) infants and 20 appropriate-for-gestational-age (AGA) controls. Infants exposed to maternal smoking, diabetes, maternal chronic diseases, or alcohol or drug use were excluded. Both groups had Apgar score ≥7 at 1 min with a normal cord pH (>7.25). Cord-serum cytokines and thrombopoietin (TPO) levels were measured by enzyme linked immunosorbent assay. C-reactive protein (CRP) was measured using a turbidometric immunoassay.


RESULTS
SGA infants had a significantly smaller birth weight than AGA controls, with a smaller gestation age by 1 week. There were significant elevations in IL-6, tumor necrosis factor (TNF-α), CRP and TPO in the SGA compared with the AGA group, which persisted in multiple regression analysis even after gestational age was taken into account.


CONCLUSIONS
As hypothesized, significant increases in the cord blood concentrations of known inflammatory markers were found in SGA infants compared with the controls.
Amarilyo
G
G
Department of Neonatology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Oren
A
A
Mimouni
F B
FB
Ochshorn
Y
Y
Deutsch
V
V
Mandel
D
D
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D002097:C-Reactive Protein / Q000378:metabolism; D036861:Delivery, Obstetric; D005260:Female; D005312:Fetal Blood / Q000378:metabolism*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn / Q000097:blood*; D007236:Infant, Small for Gestational Age / Q000097:blood*; D007249:Inflammation / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D009994:Osmolar Concentration; D013926:Thrombopoietin / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015415:Biomarkers; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D013926:Thrombopoietin