Infection and preterm birth: Evidence of a common causal relationship with bronchopulmonary dysplasia and cerebral palsy

Abstract

Subclinical genital tract infection has been clearly established as a significant cause of spontaneous preterm birth, particularly in early gestations. Bacterial vaginosis organisms rank highly among the pathogens involved in preterm labour and there is considerable beneficial evidence from the use of prophylactic antibiotics for women at high risk of preterm birth. The pathogenesis involves activation of macrophages and the generation of pro-inflammatory cytokines. Bronchopulmonary dysplasia is seen in the most immature of survivors and appears to be secondary to interruption of normal development and maturation of the lungs. The link between chorioamnionitis and lung injury in utero and subsequent development of bronchopulmonary dysplasia has now been substantiated. Exposure to pro-inflammatory cytokines is implicated in the impairment of the fetal lung. A significant body of evidence supports the association between chorioamnionitis, periventricular leukomalacia and cerebral palsy. Biological mechanisms that explain the association between chorioamnionitis and fetal brain injury involve pro-inflammatory cytokines. Similarity in the pattern of expression of cytokines suggests a common pathway for the initiation of preterm labour and also injury to the lung and the central nervous system of the fetus.

Trends in the use of preconditioning to hypoxia for early prevention of future life diseases

“…Many of these works are the epidemiologic studies with great numbers of participants, so the results of the studies are reliable. It was found that abnormalities during pregnancy might give many pathologic consequences for future offspring's life, for example: cardiovascular and cardiopulmonary diseases, including high blood pressure and risk of stroke (1)(2)(3)(4)(5)(23)(24)(25); behavioral, neurological and mental diseases, including cerebral palsy, depression, schizophrenia, epilepsy (24,(26)(27)(28)(29)(30); metabolic diseases, including overweight, type 2 diabetes (2-5,31-33); bronchopulmonary diseases, including asthma (34,35); hearing loss (36). This data show that abnormalities during pregnancy, including obstetric complications and abnormalities of early growth, are associated with or caused by some types of hypoxia.…”

A Potential Biomarker in the Cord Blood of Preterm Infants Who Develop Retinopathy of Prematurity

“…1B). Similar analyses with respect to birth weight found the same set of three biomarkers (9,15,17), as well as biomarker 19, correlated with birth weight with p Ͻ 0.02, and biomarker 5 with p ϭ 0.04. None of the globin biomarkers or transthyretin correlated with gestational age or birth weight.…”

“…The reason why some preterm infants of the same gestational age have a mild neonatal course while others go on to develop particular morbidities is of great interest to neonatologists. It has been hypothesized that the release of proinflammatory cytokines such as interleukin (IL)-6, IL-1␤, IL-8, tumor necrosis factor ␣ in amniotic fluid and other body fluids before birth may play a role in several adverse outcomes, including CLD, periventricular leukomalacia (PVL), and cerebral palsy (4,(7)(8)(9).…”

Relación Entre Doppler De La Arteria Umbilical, Invasión Microbiana De La Cavidad Amniótica, Funisitis Y Resultado Adverso Neonatal en La Rotura Prematura De Membranas De Pretérmino

“…Estos riesgos han sido relacionados con invasión microbiana de la cavidad amnió-tica (IMCA) (3-5) y en menor grado con infección cérvicovaginal (6). Las consecuencias de la infección intrauterina (corioamnionitis clínica, corioamnionitis histológica, funisitis y aumento de citoquinas intraamnióticas) en el niño se asocian con sepsis, bronconeumonía, enterocolitis necrotizante (3-5), con daños neurológicos (leucomalacia periventricular, hemorragia intraventricular, paráli-sis cerebral) y enfermedad crónica pulmonar (7)(8)(9)(10). El pronóstico adverso del neonato se ha correlacionado particularmente con la funisitis, presente en 61% de las embarazadas con IMCA (11).…”