Components of the systemic fetal inflammatory response syndrome as predictors of impaired neurologic outcomes in children

Mittendorf, Robert; Montag, Anthony; MacMillan, William; Janeczek, Susan; Pryde, Peter G.; Besinger, Richard E.; Gianopoulos, John G.; Roizen, Nancy

doi:10.1067/mob.2003.380

Cited by 86 publications

(52 citation statements)

References 22 publications

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“…The bacteriology findings from this study were previously reported as a Research Letter in The Lancet 19 and here, in the pages of the Journal of Perinatology; 20 the inflammatory cytokine and the umbilical cord and placental histology were reported elsewhere. 21,22 Screening histopathologic examinations of the umbilical cords and placentas were done by a staff pathologist. The placentas were examined after fixation in 10% buffered formalin.…”

Section: Methodsmentioning

confidence: 99%

Association between Lenticulostriate Vasculopathy (LSV) and Neonatal Intraventricular Hemorrhage (IVH)

et al. 2004

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OBJECTIVES:To determine whether there is an unconfounded association between neonatal intraventricular hemorrhage (IVH) and lenticulostriate vasculopathy (LSV (also known as thalamostriate or mineralizing vasculopathy)). STUDY DESIGN:During the conduct of the Magnesium and Neurologic Endpoints Trial (MagNET), a randomized controlled trial involving maternal, hence fetal, exposure to antenatal magnesium sulfate in the context of preterm labor, head ultrasounds were obtained for each of the surviving neonates. Because of our previous experience in the diagnosis of LSV, when ascertaining the presence of IVH, as called for by the research protocol of our study, the presence or absence of LSV was also determined. RESULTS:We found LSV to be relatively prevalent (10% (14 of 140) among surviving babies). More importantly, it was significantly associated with the occurrence of neonatal IVH, even when controlled for possible confounding (adjusted OR 9.8, 95% confidence interval 1.3 to 73.1; p ¼ 0.03). CONCLUSION:Given the known relationships between IVH and neonatal morbidity and mortality, the finding of a statistically significant association between neonatal IVH and LSV may suggest more substantial implications for the latter than previously believed.

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Section: Methodsmentioning

confidence: 99%

Association between Lenticulostriate Vasculopathy (LSV) and Neonatal Intraventricular Hemorrhage (IVH)

et al. 2004

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“…The fetal inflammatory response involving all three umbilical vessels and umbilical cord stroma demonstrates that the Bergeyella sp. is capable of activating the fetal immune system, thereby increasing the risk of central nervous system and pulmonary complications (12,31,43).…”

Section: Discussionmentioning

confidence: 99%

Transmission of an Uncultivated Bergeyella Strain from the Oral Cavity to Amniotic Fluid in a Case of Preterm Birth

Han¹,

Ikegami²,

Bissada³

et al. 2006

J Clin Microbiol

136

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Intrauterine infection is a recognized cause of preterm birth. The infectious organisms are believed to originate primarily from the vaginal tract and secondarily from other parts of the body. It is plausible that microbes in the oral cavity can be transmitted to the pregnant uterus. However, direct evidence supporting such a transmission is lacking. In this study, amniotic fluids of 34 pregnant women were examined by PCR using 16S and 23S rRNA universally conserved primers. Bacterial DNA was amplified from the only patient with clinical intrauterine infection and histologic necrotizing acute and chronic chorioamnionitis. One strain, Bergeyella sp. clone AF14, was detected and was 99.7% identical to a previously reported uncultivated oral Bergeyella strain, clone AK152, at the 16S rRNA level. The same strain was detected in the subgingival plaque of the patient but not in her vaginal tract. The 16S-23S rRNA sequence of clone AF14 matched exactly with the sequences amplified from the patient's subgingival plaque. These observations suggest that the Bergeyella strain identified in the patient's intrauterine infection originated from the oral cavity. This is the first direct evidence of oral-utero microbial transmission. The patient's periodontal health during pregnancy was unclear. She did not have detectable periodontal disease during postpartum examination. Bergeyella spp. had not been previously associated with preterm birth and were detected in subgingival plaque of women without clinical levels of intrauterine infection. Uncultivated species may be overlooked opportunistic pathogens in preterm birth. This study sheds new light on the implication of oral bacteria in preterm birth.

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“…IL-6 is one of several cytokines linked to preterm labour associated with infection (3,4) but also in the absence of apparent clinical infection (5). The intra-amniotic inflammatory response has also been associated with white matter injury and cerebral palsy and IL-6 has been shown to be an independent predictor of these serious disorders (6,7).…”

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confidence: 99%

Interleukin-6 in the Maternal Circulation Reaches the Rat Fetus in Mid-gestation

et al. 2006

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Components of the systemic fetal inflammatory response syndrome as predictors of impaired neurologic outcomes in children

Cited by 86 publications

References 22 publications

Association between Lenticulostriate Vasculopathy (LSV) and Neonatal Intraventricular Hemorrhage (IVH)

Association between Lenticulostriate Vasculopathy (LSV) and Neonatal Intraventricular Hemorrhage (IVH)

Transmission of an Uncultivated Bergeyella Strain from the Oral Cavity to Amniotic Fluid in a Case of Preterm Birth

Interleukin-6 in the Maternal Circulation Reaches the Rat Fetus in Mid-gestation

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