Plasma inflammatory and immune proteins as predictors of intra-amniotic infection and spontaneous preterm delivery in women with preterm labor: a retrospective study

Park, Hyunsoo; Park, Kyo Hoon; Kim, Yu Mi; Kook, Song Yi; Jeon, Soon‐Ik; Yoo, Hyuk Sang

doi:10.1186/s12884-018-1780-7

Cited by 58 publications

(51 citation statements)

References 38 publications

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“…Although acute gestational insults like infection are risk factors for preterm birth and intrauterine growth restriction (Fried et al, ; Park et al, ; Qiu et al, ; Rodrigues‐Duarte, Pandya, Neres, & Penha‐Gonçalves, ), recent research has demonstrated that endogenous immune processes, such as chronic inflammation, can influence birth outcomes and increase the risk for adverse birth outcomes (Kuzawa, Fried, Borja, & McDade, ; McDade et al, ). The majority of studies on inflammation and pregnancy have used C‐reactive protein (CRP), an acute phase protein that serves as a global marker of inflammation, to characterize fetal exposure to maternal inflammation (Del Giudice & Gangestad, ; Kuzawa et al, , ; McDade, ; McDade et al, ; Madonna et al, ).…”

Section: Introductionmentioning

confidence: 99%

Regulation of inflammation during gestation and birth outcomes: Inflammatory cytokine balance predicts birth weight and length

Ragsdale

Kuzawa

Borja

et al. 2019

American J Hum Biol

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Objectives The maternal environment during gestation influences offspring health at birth and throughout the life course. Recent research has demonstrated that endogenous immune processes such as dysregulated inflammation adversely impact birth outcomes, increasing the risk for preterm birth and restricted fetal growth. Prior analyses examining this association suggest a relationship between maternal C‐reactive protein (CRP), a summary measure of inflammation, and offspring anthropometric outcomes. This study investigates pro‐ and anti‐inflammatory cytokines, and their ratio, to gain deeper insight into the regulation of inflammation during pregnancy. Methods IL6, IL10, TNFɑ, and CRP were quantified in dried blood spots collected in the early third trimester (mean = 29.9 weeks) of 407 pregnancies in Metropolitan Cebu, Philippines. Relationships between these immune markers and offspring anthropometrics (birth weight, length, head circumference, and sum of skinfold thicknesses) were evaluated using multivariate regression analyses. Ratios of pro‐ to anti‐inflammatory cytokines were generated. Results Higher maternal IL6 relative to IL10 was associated with reduced offspring weight and length at birth. Individual cytokines did not predict birth outcomes. Conclusions Consistent with the idea that the relative balance of cytokines with pro‐ and anti‐inflammatory effects is a key regulator of inflammation in pregnancy, the IL6:IL10 ratio, but neither cytokine on its own, predicted offspring birth outcomes. Our findings suggest that prior reports of association between CRP and fetal growth may reflect, in part, the balance between pro‐ and anti‐inflammatory cytokines, and that the gestational environment is significantly shaped by cytokine imbalance.

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Section: Introductionmentioning

confidence: 99%

Regulation of inflammation during gestation and birth outcomes: Inflammatory cytokine balance predicts birth weight and length

Ragsdale

Kuzawa

Borja

et al. 2019

American J Hum Biol

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“…These inflammatory cytokines could activate decidual immune cells, and PGE 2 induces uterine contractions. High levels of serum and amniotic fluid inflammatory mediators were associated with APO, especially PTB . A systematic review reported a positive association between APO and inflammatory mediator levels in gingival crevicular fluid, which is an inflammatory exudate from the gingival margin or within the gingival crevice .…”

Section: Inflammatory Mediators Produced By Gingival Submucosamentioning

confidence: 99%

Periodontal diseases and adverse pregnancy outcomes

Komine‐Aizawa

Aizawa

Hayakawa

2018

J of Obstet and Gynaecol

112

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From last decade of the 20th century, numerous epidemiological studies and intervention trials have attempted to prove the relationships between maternal periodontal diseases and adverse pregnancy outcomes (APO). Periodontal diseases are considered a risk factor for APO, including preterm birth, fetal growth restriction, low birthweight, pre-eclampsia and gestational diabetes. However, the efficacy of periodontal treatment during pregnancy is controversial. Two pathogenic mechanisms might explain the potential effect of periodontal diseases on pregnancy outcomes. First, periodontal bacteria originating in the gingival biofilm directly affect the feto-placental unit subsequent to bacteremia. Second, inflammatory mediators secreted by the subgingival inflammatory site are carried to the feto-placental unit, where they then cause an inflammatory response. To elucidate these mechanisms, many researchers have been investigating the use of experimental animal models and in vitro models. In the present review, we summarize the current literature on the relationship between periodontal diseases and APO from epidemiological studies, animal models studies and in vitro studies, and speculate on the possible mechanism of periodontal diseases affecting pregnancy outcomes.

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“…Given that the prevalence of intra-amniotic infection is increased in laboring women with preterm PROM [32,73], it is tempting to suggest that the process of labor facilitates the ascension of microorganisms into the amniotic cavity [18,[74][75][76][77]. In line with this concept, several reports have shown that approximately 40% of women with preterm PROM have intra-amniotic infection [32,62,[78][79][80]. Importantly, molecular microbiology is capable of detecting 50% more cases of microbial invasion of the amniotic cavity than conventional microbiological cultures [32].…”

Section: Introductionmentioning

confidence: 99%

Microbial burden and inflammasome activation in amniotic fluid of patients with preterm prelabor rupture of membranes

Theis

Romero

Motomura

et al. 2020

Journal of Perinatal Medicine

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Background Intra-amniotic inflammation, which is associated with adverse pregnancy outcomes, can occur in the presence or absence of detectable microorganisms, and involves activation of the inflammasome. Intra-amniotic inflammasome activation has been reported in clinical chorioamnionitis at term and preterm labor with intact membranes, but it has not yet been investigated in women with preterm prelabor rupture of membranes (preterm PROM) in the presence/absence of detectable microorganisms. The aim of this study was to determine whether, among women with preterm PROM, there is an association between detectable microorganisms in amniotic fluid and intra-amniotic inflammation, and whether intra-amniotic inflammasome activation correlates with microbial burden. Methods Amniotic fluids from 59 cases of preterm PROM were examined for the presence/absence of microorganisms through culture and 16S ribosomal RNA (rRNA) gene quantitative real-time polymerase chain reaction (qPCR), and concentrations of interleukin-6 (IL-6) and ASC [apoptosis-associated spec-like protein containing a caspase recruitment domain (CARD)], an indicator of inflammasome activation, were determined. Results qPCR identified more microbe-positive amniotic fluids than culture. Greater than 50% of patients with a negative culture and high IL-6 concentration in amniotic fluid yielded a positive qPCR signal. ASC concentrations were greatest in patients with high qPCR signals and elevated IL-6 concentrations in amniotic fluid (i.e. intra-amniotic infection). ASC concentrations tended to increase in patients without detectable microorganisms but yet with elevated IL-6 concentrations (i.e. sterile intra-amniotic inflammation) compared to those without intra-amniotic inflammation. Conclusion qPCR is a valuable complement to microbiological culture for the detection of microorganisms in the amniotic cavity in women with preterm PROM, and microbial burden is associated with the severity of intra-amniotic inflammatory response, including inflammasome activation.

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Plasma inflammatory and immune proteins as predictors of intra-amniotic infection and spontaneous preterm delivery in women with preterm labor: a retrospective study

Cited by 58 publications

References 38 publications

Regulation of inflammation during gestation and birth outcomes: Inflammatory cytokine balance predicts birth weight and length

Regulation of inflammation during gestation and birth outcomes: Inflammatory cytokine balance predicts birth weight and length

Periodontal diseases and adverse pregnancy outcomes

Microbial burden and inflammasome activation in amniotic fluid of patients with preterm prelabor rupture of membranes

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