title: Systemic inflammation in the extremely low gestational age newborn following maternal genitourinary infections.
abstract: OBJECTIVE
  Gestational genitourinary infections are associated with lifelong disabilities, but it is unknown if neonatal inflammation is involved.
  
  
  METHODS
  Mothers of 914 infants born before 28th gestation week reported cervical/vaginal infection (CVI), and/or urine/bladder/kidney infection (UTI), or neither. Inflammation proteins measured in baby's blood on postnatal days 1, 7, and 14 were considered elevated if in the top quartile for gestational age. Logistic regression models adjusting for potential confounders assessed odds ratios.
  
  
  RESULTS
  Compared to mothers with neither UTI/CVI, those with CVI were more likely to have infants with elevated CRP, SAA, MPO, IL-1β, IL-6, IL-6R, TNF-α, RANTES, ICAM-3, E-selectin, and VEGF-R2 on day 1; those with UTI were more likely to have infants with elevated MPO, IL-6R, TNF-R1, TNF-R2, and RANTES on day 7. Placental anaerobes and genital mycoplasma were more common in pregnancies with CVI.
  
  
  CONCLUSIONS
  Gestational UTI/CVI should be targeted for preventing systemic inflammation in the very preterm newborn.
authors.affiliation: Laboratory of Genital Tract Biology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Raina N
authors.initials: RN
authors.lastname: Fichorova
authors.forename: Noah
authors.initials: N
authors.lastname: Beatty
authors.forename: Rita R S
authors.initials: RR
authors.lastname: Sassi
authors.forename: Hidemi S
authors.initials: HS
authors.lastname: Yamamoto
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Allred
authors.forename: Alan
authors.initials: A
authors.lastname: Leviton
mesh_terms: D000328:Adult; D015703:Antigens, CD / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D015815:Cell Adhesion Molecules / Q000097:blood; D016207:Cytokines / Q000097:blood; D019040:E-Selectin / Q000097:blood; D005260:Female; D052776:Female Urogenital Diseases / Q000453:epidemiology*; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature / Q000097:blood*; D007231:Infant, Newborn; D007249:Inflammation / Q000097:blood / Q000453:epidemiology*; D008297:Male; D009195:Peroxidase / Q000097:blood; D011247:Pregnancy; D011956:Receptors, Cell Surface / Q000097:blood; D055815:Young Adult
chemical_list: D015703:Antigens, CD; D015815:Cell Adhesion Molecules; D016207:Cytokines; D019040:E-Selectin; C483616:ICAM3 protein, human; D011956:Receptors, Cell Surface; D002097:C-Reactive Protein; D009195:Peroxidase
keywords: Acute phase proteins; cervicitis; cytokines; placental microbiome; preterm birth; vaginitis