Increased inflammatory markers are associated with early periventricular leukomalacia

Tsukimori, Kiyomi; Komatsu, Hajime; Yoshimura, Takazumi; Hikino, Shunji; Hara, Toshiro; Wake, Norio; Nakano, Hitoo

doi:10.1111/j.1469-8749.2007.00587.x

Cited by 20 publications

(14 citation statements)

References 15 publications

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“…NOX1 is the major enzymatic mediator of superoxide anion generation in neutrophils (42). Increased expression of NOX1 by neonatal neutrophils is consistent with previous reports that in response to inflammatory stimuli, these cells produce greater amounts of superoxide anion relative to adult cells (43). Of note is our observation that constitutive expression of NOX1 was lower in neonatal relative to adult cells.…”

Section: Discussionsupporting

confidence: 91%

Inflammatory Effects of Phthalates in Neonatal Neutrophils

et al. 2010

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IV infusion of crystalloid fluids and drugsBased on the results of the safety assessment, CDRH concludes that there is little to no risk posed by patient exposure to the amount of DEHP released from PVC IV bags following infusion of crystalloid fluids (e.g., normal saline, D5W, Ringers Lactate). Further, there is little risk posed by exposure to the amount of DEHP released from PVC bags used to store and administer drugs that require a pharmaceutical vehicle for solubilization, when label instructions are followed. Total Parenteral Nutrition (TPN)The dose of DEHP received by adult patients receiving TPN admixtures is estimated to be less than the TI, suggesting that there is little concern for DEHP-mediated effects in these patients. In addition, non-PVC bags and tubing are typically used to administer TPN, further lessening the concern about DEHP-mediated effects.The dose of DEHP received by neonates undergoing TPN supplementation is uncertain. The results of one study suggest that neonates can receive a very high dose of DEHP, whereas another suggests that neonates receive doses of DEHP from TPN that are equivalent to the TI. Therefore, depending on the data used to derive the TI/dose ratio, neonates receiving TPN admixtures with lipid may be at increased risk of DEHP-mediated adverse effects. Blood transfusionRelatively high doses of DEHP can be received by patients who are transfused with large volumes of blood and blood products over a short period (e.g., trauma or surgical patients receiving massive transfusions). However, the TI/dose ratio for this procedure is likely to overestimate the actual risk to these patients, since the TI is intended to be protective for longterm exposures, compared to relatively short-term exposure in acute transfusions. In contrast, a patient undergoing a routine, elective surgical procedure typically receives about two units of packed red blood cells. Transfusion of this volume of blood will result in a DEHP dose equivalent to the TI value, approximately 0.5 mg/kg/day. Long-term transfusion of blood to patients with anemia results in a DEHP dose about an order of magnitude lower. Similarly, infants who receive replacement transfusions in the NICU receive relatively small DEHP doses from the transfusions. Apheresis donors are exposed to relatively little DEHP when the dose is time-averaged over an extended period. Consequently, there is little concern about DEHP-associated adverse effects developing in persons donating platelets or plasma.Two subpopulations of patients that may be at increased risk from exposure to DEHP following transfusions are infants undergoing exchange transfusion and adults undergoing ECMO. However, neither of these procedures is done very often, so the patient population exposed to relatively large doses of DEHP via exchange transfusion or replacement transfusion of adults on ECMO is expected to be small. Cardiopulmonary bypass and ECMOThe aggregate dose of DEHP received by adults undergoing cardiopulmonary bypass procedures may equal or exceed the TI in...

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Section: Discussionsupporting

confidence: 91%

Inflammatory Effects of Phthalates in Neonatal Neutrophils

et al. 2010

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“…We also confirmed the several reports of a significant association between cPVL and chorioamnionitis [8, 9, 11, 14, 15]. The fact that only one cPVL baby had a positive blood culture within 3 days of birth supports the hypothesis that fetal inflammatory response syndrome is perfectly capable of causing brain damage even in the absence of bacteremia [32–34].…”

Section: Discussionsupporting

confidence: 90%

Latency after Preterm Prelabor Rupture of the Membranes: Increased Risk for Periventricular Leukomalacia

Denzler

Burkhardt

Natalucci

et al. 2014

Journal of Pregnancy

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Objective. To identify the risk factors for cystic periventricular leukomalacia (cPVL) and their implications for deciding between immediate delivery and conservative management of preterm prelabor rupture of the membranes (pPROM). Methods. The following risk factors were compared between cPVL infants and 6440 controls: chorioamnionitis, sex, gestational age (GA), birth weight, pPROM, and pPROM-delivery interval. Factor impact on cPVL risk and clinical decision-making was determined by multivariate logistic regression. Results. Overall cPVL prevalence (n = 32) was 0.99/1000 births. All cPVL infants but one were born <34 weeks of gestation and were <2500 g; 56% had histological chorioamnionitis versus 1.1% of controls (OR 35.9; 95%-CI 12.6–102.7). Because chorioamnionitis is a postnatal diagnosis, logistic regression was performed with prenatally available factors: pPROM-delivery interval >48 hours (OR 9.0; 95%-CI 4.1–20.0), male gender (OR 3.2; 95%-CI 1.4–7.3). GA was not a risk factor if birth weight was included. Risk decreased with increasing fetal weight despite a prolonged pPROM-delivery interval. Conclusion. pPROM-delivery interval is the single most important prenatally available risk factor for the development of cPVL. Immediate delivery favors babies with chorioamnionitis but disfavors those with non infectious pPROM. In the absence of clinical chorioamnionitis fetal weight gain may offset the inflammatory risk of cPVL caused by a prolonged pPROM-delivery interval.

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“…In a recent study, preterm infants with early WMD as detected by ultrasound and confirmed by MRI had higher cord blood concentrations of TNF-␣ and IL-1␤ (30). Both white and gray matter abnormalities detected by MRI in preterm infants have been associated with abnormal functional outcome (5).…”

Section: Discussionmentioning

confidence: 99%

Inflammation at Birth is Associated With Subnormal Development in Very Preterm Infants

et al. 2008

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Preterm birth carries a risk for impaired developmental outcome. We have previously described an association between increased levels of proinflammatory cytokines during the first 72 postnatal hours and cerebral damage as detected by ultrasound in a cohort of 74 very preterm infants. Sixty-seven of 71 surviving children with a mean gestational age of 27.1 (2.0) wk were examined at 2 y corrected age with a standardized neurologic examination and with Bayley Scales of Infant Development. We hypothesized that proinflammatory cytokine concentrations at or shortly after birth would be associated with an adverse developmental outcome. Increased concentrations of TNF-␣ in cord blood odds ratio (95% confidence interval) 3.3 (1.1-10.2), p ϭ 0.013 and at 6 h 7.8 (0.9 -71.8), p ϭ 0.015 and of IL-6 in cord blood 1.7 (1.0 -2.9), p ϭ 0.048 were associated with psychomotor developmental index Ͻ85. Increased concentrations of TNF-␣ in cord blood odds ratio (95% confidence interval) 3.6 (1.002-12.8), p ϭ 0.044 and of IL-8 in cord blood 3.5 (1.2-10.6), p ϭ 0.023 were associated with cerebral palsy. Associations of TNF-␣ and IL-8 in cord blood with the respective outcome measures remained significant after adjustment for other clinical variables. Proinflammation at birth is associated with impaired functional outcome at 2 y of corrected age in children with very preterm birth. (Pediatr Res 64: 183-188, 2008)

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Increased inflammatory markers are associated with early periventricular leukomalacia

Cited by 20 publications

References 15 publications

Inflammatory Effects of Phthalates in Neonatal Neutrophils

Inflammatory Effects of Phthalates in Neonatal Neutrophils

Latency after Preterm Prelabor Rupture of the Membranes: Increased Risk for Periventricular Leukomalacia

Inflammation at Birth is Associated With Subnormal Development in Very Preterm Infants

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