C-reactive protein in umbilical cord blood: a simple and widely available clinical method to assess the risk of amniotic fluid infection and funisitis

Yoon, Bo Hyun; Romero, Roberto; Shim, Ji-Yeon; Shim, Soon Sup; Kim, C J; Jun, Jong Kwan

doi:10.1080/jmf.14.2.85.90

Cited by 100 publications

(58 citation statements)

References 18 publications

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“…An increase of monocyte concentration was also observed. However, total white cell count and CRP did not seem useful in the diagnosis of intrauterine infection or fetal inflammation, although in other studies appreciable associations have been found 19 31. The numbers of mother–infant pairings studied here do not allow firm conclusions to be drawn although the colonised group did have decreased radiological evidence of RDS.…”

Section: Discussioncontrasting

confidence: 71%

Fetal cortisol response to intrauterine microbial colonisation identified by the polymerase chain reaction and fetal inflammation

Miralles

Hodge

Kotecha

2007

Arch Dis Child Fetal Neonatal Ed

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Section: Discussioncontrasting

confidence: 71%

Fetal cortisol response to intrauterine microbial colonisation identified by the polymerase chain reaction and fetal inflammation

Miralles

Hodge

Kotecha

2007

Arch Dis Child Fetal Neonatal Ed

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“…FIRS is associated with an increase in pro-inflammatory cytokines (e.g. IL-1β, TNF-α)[87], chemokine (IL-8)[54], and C-reactive protein [185] in umbilical cord blood, which may lead to short- and long-term complications in preterm neonates [21,55,57,58,67,86,87,89,185–191]. On the other hand, as confirmed by the study herein, FIRS is also associated with an increased umbilical cord plasma concentration of IL-10 [192,193].…”

Section: Discussionmentioning

confidence: 99%

Soluble ST2 in the fetal inflammatory response syndrome:in vivoevidence of activation of the anti-inflammatory limb of the immune response

Stampalija

Romero

Korzeniewski

et al. 2013

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective Inflammation is a mechanism of host response to infection which can be harmful when inappropriately modulated. Soluble ST2 (sST2) is a decoy receptor of interleukin (IL)-33, and this complex modulates the balance in the Th1/Th2 immune response. Moreover, sST2 inhibits the production of pro-inflammatory cytokines in cooperation with an anti-inflammatory cytokine, IL-10. The objectives of this study were to: 1) determine whether umbilical cord plasma sST2 concentration differ between comparing preterm neonates with and without funisitis and between those with and without the fetal inflammatory response syndrome (FIRS); and 2) evaluate the relationship between sST2 and IL-10 among neonates with funisitis and/or FIRS. Methods Umbilical cord plasma was collected from neonates delivered prematurely due to preterm labor or preterm prelabor rupture of membranes with (n=36), and without funisitis (n=30). FIRS (umbilical cord IL-6 concentration ≥17.5 pg/mL) was identified in 29 neonates. Plasma sST2 and IL-10 concentrations were determined by ELISA. Results The median umbilical cord plasma sST2 concentration was 6.7-fold higher in neonates with FIRS than in those without FIRS (median 44.6 ng/mL, interquartile range [IQR] 13.8–80.3 ng/mL vs. median 6.7 ng/mL, IQR 5.6–20.1 ng/mL; p<0.0001). Similarly, the median umbilical cord plasma sST2 concentration was 2.6-fold higher in neonates with funisitis than in those without funisitis (median 19.1 ng/mL; IQR 7.1–75.0 ng/mL vs. median 7.2 ng/mL; IQR 5.9–23.1 ng/mL; p=0.008). There was a strong positive correlation between sST2 and IL-10 in neonates with funisitis and/or FIRS (Spearman’s Rho=0.7, p<0.0001). Conclusions FIRS and funisitis are associated with an elevation of umbilical cord plasma concentrations of soluble ST2. This protein represents an important mediator of the immune response in neonates diagnosed with fetal inflammatory response syndrome by promoting an anti-inflammatory effect in association with IL-10.

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“…Maternal fever during labor or delivery, premature rupture of fetal membranes, perinatal asphyxia and other problems not resulting from infection were found to be associated with elevated CRP levels in umbilical cord blood [21]. However, it has recently been demonstrated that CRP levels in umbilical cord plasma at birth are increased in neonates with sepsis, funisitis, or who were born to mothers with microbial invasion of the amniotic cavity [22].…”

Section: C-reactive Proteinmentioning

confidence: 97%

Immunologic markers in the neonatal period: diagnostic value and accuracy in infection

Kafetzis¹,

Tigani²,

Costalos

2005

Expert Review of Molecular Diagnostics

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Diagnosis of early-onset neonatal infection has led to the development of several screening tests including C-reactive protein, a very commonly used marker, and cytokines (mainly interleukin-6 and -8), alone or in combination with C-reactive protein, based on the premise that their increases in response to infection may precede that of C-reactive protein. In recent years the search for diagnostic tests has turned to procalcitonin, a propeptide of calcitonin, which appears to be a promising marker of infection in newborn infants. Additionally, specific leukocyte cell surface antigens (mainly CD11b and CD64), detected by flow cytometry, are evaluated as markers of neonatal infection, since their expression on the cell membrane increases in substantial quantities after leukocyte activation by bacteria or their cellular products. This review aims to examine the role of these newly available immunologic indices and to assess their validity as diagnostic markers of infection during the neonatal period.

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C-reactive protein in umbilical cord blood: a simple and widely available clinical method to assess the risk of amniotic fluid infection and funisitis

Abstract: Umbilical cord plasma CRP concentrations were elevated in patients with amniotic fluid infection, congenital neonatal sepsis and funisitis.

Cited by 100 publications

References 18 publications

Fetal cortisol response to intrauterine microbial colonisation identified by the polymerase chain reaction and fetal inflammation

Fetal cortisol response to intrauterine microbial colonisation identified by the polymerase chain reaction and fetal inflammation

Soluble ST2 in the fetal inflammatory response syndrome:in vivoevidence of activation of the anti-inflammatory limb of the immune response

Immunologic markers in the neonatal period: diagnostic value and accuracy in infection

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