Patterns of increases in interleukin‐6 and <scp>C</scp>‐reactive protein as predictors for white matter injury in preterm infants

Inomata, Kei; Mizobuchi, Masami; Tanaka, Satoshi; Iwatani, Sota; Sakai, Hitomi; Yoshimoto, Seiji; Nakao, Hideto

doi:10.1111/ped.12376

Cited by 19 publications

(15 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…11 High levels of CRP and interleukin-6 at birth correlated with more white matter injury in preterm infants with foetal inflammatory response. 29 We found that grades III and IV haemorrhage, which are associated with spastic diplegia more strongly correlated with gestational age than with HCA. Although we found statistically significant outcomes in the HCA group with more bronchopulmonary dysplasia, retinopathy of prematurity, patent ductus arteriosus, early-onset sepsis and grade III/IV intraventricular haemorrhage in the HCA group, this disappears when corrected for gestational age.…”

Section: Discussionmentioning

confidence: 52%

Histological chorioamnionitis is predicted by early infant C‐reactive protein in preterm infants and correlates with neonatal outcomes

et al. 2019

View full text Add to dashboard Cite

Aim Histological chorioamnionitis (HCA) is associated with preterm birth and adverse neonatal outcomes. We evaluated the rise in C‐reactive protein (CRP) in preterm infants as a predictor of HCA severity and outcomes. Methods Consecutive preterm infants, born January 2009 to January 2014 in the National Maternity Hospital, Dublin, under 32 weeks' gestation or <1.5 kg birthweight, were included. Histological chorioamnionitis was staged as maternal inflammatory response, foetal inflammatory response and non‐HCA. Results Preterm infants (n = 518) were included with a mean gestational age 28.5 ± 2.8 weeks, birthweight 1.1 ± 0.3 kg, and 53.5% were male. Histological chorioamnionitis was found in 25.4%. Histological chorioamnionitis was present in 93.7% when CRP > 5 mg/L, 65.2% when CRP 1‐5 mg/L and in 19.4% when CRP < 1 mg/L. When both the immature to total neutrophil (IT) ratio was >0.2 and the CRP > 1 mg/L the positive predictive value and negative predictive value for HCA were 92.5% and 84.9%, respectively. Histological chorioamnionitis was associated with more resuscitation and respiratory distress syndrome (both P < .001). A CRP > 10 mg/L was associated with a foetal inflammatory response and increased early‐onset sepsis. Conclusion Higher early CRP was a surrogate predictor of HCA and correlated with the severity of HCA. Higher CRP and HCA were associated with adverse early outcomes.

show abstract

Section: Discussionmentioning

confidence: 52%

Histological chorioamnionitis is predicted by early infant C‐reactive protein in preterm infants and correlates with neonatal outcomes

et al. 2019

View full text Add to dashboard Cite

show abstract

“…A body of research has suggested that prenatal infection and resultant fetal inflammatory response contribute to the pathogenesis of severe neonatal neurologic illness, such with white matter injury (WMI) [ 31 , 32 ], which in turn was associated with an increased risk of neurosensory impairment (hearing or vision) [ 33 , 34 ], and elevated blood CRP levels at birth were associated with WMI in preterm infants [ 35 ]. However, to date, no study has evaluated the direct relationship between immediate postnatal blood CRP levels (at or immediately after birth) and hearing status in preterm infants.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory and Immune Proteins in Umbilical Cord Blood: Association with Hearing Screening Test Failure in Preterm Neonates

Shim

Choi

Park

et al. 2018

Mediators of Inflammation

View full text Add to dashboard Cite

Objective We aimed to determine whether elevated levels of various inflammatory and immune proteins in umbilical cord blood are associated with an increased risk of newborn hearing screening (NHS) test failure in preterm neonates. Methods This retrospective cohort study included 127 premature singleton infants who were born at ≤33.6 weeks. Umbilical cord plasma at birth was assayed for interleukin (IL)-6, complement C3a and C5a, matrix metalloproteinase (MMP)-9, macrophage colony-stimulating factor (M-CSF), and endostatin levels using ELISA kits. Neonatal blood C-reactive protein (CRP) levels were measured within 2 hours of birth. The primary outcome measure was a uni- or bilateral refer result on an NHS test. Univariate and multivariate analyses were applied. Results Fifteen (11.8%) infants failed the NHS test. In the univariate analyses, high IL-6 and low C3a levels in umbilical cord plasma, funisitis, and an elevated CRP level (>5 mg/L) in the immediate postnatal period were significantly associated with NHS test failure. However, the levels of umbilical cord plasma MMP-9, C5a, M-CSF, and endostatin were not significantly different between infants who passed and those who failed the NHS test. Multiple logistic regression analyses indicated that elevated umbilical cord plasma C3a levels were independently associated with a reduced risk of NHS test failure, whereas elevated levels of umbilical cord plasma IL-6 and high CRP levels in the immediate postnatal period were significantly associated with NHS test failure. Conclusions Our data demonstrated that in preterm neonates, a systemic fetal inflammatory response reflected by umbilical cord plasma IL-6 and immediate postnatal CRP levels may contribute to the risk for NHS test failure, whereas the changes in complement activation fragments initiated in utero may have protective effect of hearing screen failure.

show abstract

“…These outcomes may be related to early brain injury associated with high levels of systemic inflammation (Korzeniewski et al, ). Using markers of neurological impairment, including abnormalities on cranial ultrasound or magnetic resonance imaging or depressed electroencephalogram activity, some researchers have associated inflammation with brain injury in preterm infants (Inomata et al, ; Korzeniewski et al, ; Wikstrom, Ley, Hansen‐Pupp, Rosen, & Hellstrom‐Westas, ). Similarly, investigators have found associations between markers of neonatal inflammation and long‐term neurodevelopmental impairment, as measured by impaired behavioral, mental, and motor functioning (Kinjo et al, ; Korzeniewski et al, ; O'Shea et al, ).…”

Section: Neonatal Stress Embedding Modelmentioning

confidence: 99%

The biological embedding of neonatal stress exposure: A conceptual model describing the mechanisms of stress‐induced neurodevelopmental impairment in preterm infants

Nist

Harrison

Steward

2018

Research in Nursing & Health

View full text Add to dashboard Cite

The biological embedding of early life stress exposure may result in life‐long neurodevelopmental impairment in preterm infants. Infants hospitalized in the neonatal intensive care unit are exposed to significant experiential, environmental, and physiologic stressors over the course of their extended hospitalization. Stress exposure during the sensitive period of brain development may alter biological processes, including functioning of the immune system, the autonomic nervous system, and the hypothalamic‐pituitary‐adrenal axis as well as gene expression. These alterations may subsequently affect brain structure and function. Changes to these processes may mediate the relationship between neonatal stress exposure and neurodevelopment in preterm infants and represent potential therapeutic targets to improve long‐term outcomes. The purpose of this paper is to introduce a conceptual model, based on published research, that describes the mechanisms mediating stress exposure and neurodevelopment impairment in preterm infants and to provide the theoretical foundation on which to base future descriptive research, intervention studies, and clinical care.

show abstract

Patterns of increases in interleukin‐6 and C‐reactive protein as predictors for white matter injury in preterm infants

Abstract: A combined elevation in serum IL-6 and CRP levels at birth was associated with the development of WMI in preterm infants with FIR.

Cited by 19 publications

References 25 publications

Histological chorioamnionitis is predicted by early infant C‐reactive protein in preterm infants and correlates with neonatal outcomes

Histological chorioamnionitis is predicted by early infant C‐reactive protein in preterm infants and correlates with neonatal outcomes

Inflammatory and Immune Proteins in Umbilical Cord Blood: Association with Hearing Screening Test Failure in Preterm Neonates

The biological embedding of neonatal stress exposure: A conceptual model describing the mechanisms of stress‐induced neurodevelopmental impairment in preterm infants

Contact Info

Product

Resources

About