The relationship between amniotic fluid matrix metalloproteinase-8 and funisitis

Park, Joong Shin; Romero, Roberto; Yoon, Bo Hyun; Moon, Jeong Mi; Oh, Soo‐Young; Han, Soo‐Yeon; Ko, Eunyoung

doi:10.1067/mob.2001.117679

Cited by 115 publications

(123 citation statements)

References 24 publications

Supporting

Mentioning

119

Contrasting

Order By: Relevance

“…These observations are consistent with those previously reported by many investigators in preterm gestations [3,6,[14][15][16]. An explanation for this association is that microbial invasion of the amniotic cavity elicits a fetal inflammatory response, which can be detected by examination of the amniotic fluid or the umbilical Table II.…”

Section: The Clinical Significance Of Funisitissupporting

confidence: 82%

“…Funisitis, inflammation of the umbilical cord, represents a fetal inflammatory response and is the histologic hallmark of FIRS [3,4]. Previous studies have provided evidence of an association between funisitis and adverse perinatal outcome, specifically, neonatal infection-related complications and cerebral palsy in preterm neonates [3,5,6]. There is a paucity of information about the frequency and clinical significance of funisitis in term gestations.…”

Section: Introductionmentioning

confidence: 95%

“…Our impression is that the first explanation is not likely because we did not observe villitis, which is generally seen in hematogenous infections. Isolated funisitis has been observed in 5-8% of preterm gestations [3,6] and thus it is more frequent in term gestations. Further studies are required to examine the clinical significance (short and long-term) of funisitis at term.…”

Section: Funisitis and Histologic Chorioamnionitismentioning

confidence: 99%

See 2 more Smart Citations

Funisitis in term pregnancy is associated with microbial invasion of the amniotic cavity and intra-amniotic inflammation

Lee

Romero

Kim

et al. 2006

The Journal of Maternal-Fetal & Neonatal Medicine

Self Cite

View full text Add to dashboard Cite

Objective. Funisitis is the histologic counterpart of the fetal inflammatory response syndrome, which is a multisystemic disorder associated with impending preterm delivery and adverse neonatal outcome. The purpose of this study was to examine the relationship between funisitis and the microbiologic status of amniotic fluid (AF) and AF white blood cell (WBC) count in patients at term. Methods. The relationship between the presence of funisitis, AF culture, and AF WBC count was examined in 832 consecutive patients who delivered a term neonate within 72 hours of amniocentesis. AF was cultured for aerobic and anaerobic bacteria, as well as for mycoplasmas. Funisitis was diagnosed in the presence of neutrophil infiltration into the umbilical vessel walls or Wharton's jelly. AF WBC count was analyzed in a hemocytometer chamber. Nonparametric statistics were used for data analysis. Results. Funisitis was present in 4% (30/832) of cases. A positive AF culture was more common in cases with funisitis than in those without funisitis (17% vs. 5%; p 5 0.05). Patients with funisitis had a significantly higher median AF WBC count than those without funisitis (median 41000 cells/mm 3 vs. median 2 cells/mm 3 ; p 5 0.001). The frequency of funisitis and of a positive AF culture was 1% in women without labor and with intact membranes and the frequencies and the median AF WBC count increased in the presence of labor or rupture of membranes. Conclusion. Funisitis is present in 4% of women at term and is associated with microbial invasion of the amniotic cavity (MIAC) and inflammation as reflected by increased AF WBC count.

show abstract

Section: The Clinical Significance Of Funisitissupporting

confidence: 82%

Section: Introductionmentioning

confidence: 95%

Section: Funisitis and Histologic Chorioamnionitismentioning

confidence: 99%

See 1 more Smart Citation

Funisitis in term pregnancy is associated with microbial invasion of the amniotic cavity and intra-amniotic inflammation

Lee

Romero

Kim

et al. 2006

The Journal of Maternal-Fetal & Neonatal Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…To exclude the possibility of a change in the inflammatory status of the AF due to a prolonged amniocentesis-to-delivery interval affecting the presence of histologic funisitis, we also applied our analysis to cases delivered within 72 h from the time of the amniocentesis (n ϭ 77) (26). For this subset analysis, an MR score 3-4, but not the AF WBC count, remained in our model as the single most significant predictor of acute funisitis (OR: 11.…”

Section: Resultsmentioning

confidence: 99%

Proteomic Biomarkers of Intra-amniotic Inflammation: Relationship with Funisitis and Early-onset Sepsis in the Premature Neonate

Buhimschi

Abdel-Razeq

et al. 2007

Pediatr Res

View full text Add to dashboard Cite

ABSTRACT:Our goal was to determine the relationship between 4 amniotic fluid (AF) proteomic biomarkers (human neutrophil defensins 2 and 1, calgranulins C and A) characteristic of intra-amniotic inflammation, and funisitis and early-onset sepsis in premature neonates. The mass restricted (MR) score was generated from AF obtained from women in preterm labor (n ϭ 123). The MR score ranged from 0 -4 (none to all biomarkers present). Funisitis was graded histologically and interpreted in relation to the MR scores. Neonates (n ϭ 97) were evaluated for early-onset sepsis. There was significant correlation between the severity of AF inflammation and the presence (53/123) and grades of funisitis (p Ͻ 0.001). Funisitis occurred independently of the amniocentesis-to-delivery interval or status of the membranes and was best predicted by an MR score 3-4 and an earlier gestational age (GA) at delivery. Neonates born to women with an MR score 3-4 had an increased incidence of suspected/confirmed sepsis, even after adjusting for GA at birth. Calgranulin C had the highest association with clinically significant funisitis, while calgranulin A had the strongest association with early-onset sepsis. To conclude, AF proteomic analysis shows that women with MR scores 3-4 are more likely to have histologic funisitis, and deliver neonates with early-onset sepsis. the rate of preterm birth (PTB) has actually increased over the past 20 y (1). More than 500,000 preterm infants were born in the United States in 2004 (1). Interventions to prevent PTB and its consequences for the fetus should predominantly be targeted at the prevention, early recognition and treatment of several risk factors including intra-amniotic inflammation/ infection (2).Robust scientific evidence has confirmed that when intraamniotic inflammation secondary to, or independent of infection is superimposed upon prematurity, the consequences for the neonate can prove devastating (3,4). This association can be explained by an inflammatory cytokine cascade that seems to be, at least partially, of fetal origin (5,6). Indeed, fetal umbilical vein inflammatory cytokine levels, but not maternal serum values, correlate with the presence and severity of the placental histologic inflammation and umbilical cord vasculitis (7).Funisitis is characterized by perivascular infiltrates of inflammatory cells and is considered one of the strongest hallmarks of microbial invasion of the amniotic cavity and fetal inflammatory syndrome (8,9). While there is some debate with regard to the origin of the amniotic fluid (AF) neutrophilic response to infection (10), there is consensus that the fetal inflammatory neutrophilic response originates initially from the umbilical vein and later from the arteries leading to umbilical cord vasculitis and funisitis (11). Funisitis is a well-recognized risk factor for early-onset sepsis in the premature neonate (12,13).We have previously shown that proteomic mapping of the AF reveals a profile, designated as the Mass Restricted (MR) score, that is highly cha...

show abstract

“…105 Histopathological evidence of this inflammatory response is present when funisitis (inflammation of the umbilical cord) and chorioamnionitis are confirmed. It is characterised by increased levels of proinflammatory blood cells in the amniotic fluid and the accumulation of inflammatory blood cells (polymorphonuclear leukocytes) in the umbilical cord and chorion.…”

Section: Viral Infection and The Fetal Response To Infectionmentioning

confidence: 99%

The Antenatal Causes of Cerebral Palsy – Genetic and Viral Associations

Gibson

MacLennan

Goldwater

et al. 2008

Fet. Matern. Med. Rev.

View full text Add to dashboard Cite

Cerebral palsy is the most common neurological disorder in children. Epidemiological evidence suggests that antenatal origins are a major cause. Currently there is no antenatal test for cerebral palsy, no proven preventable measures in late pregnancy, and no known cure. Cerebral palsy affects not only the diagnosed child, but also their family and the community, requiring considerable social and financial resources to assist these children in their daily lives.

show abstract

The relationship between amniotic fluid matrix metalloproteinase-8 and funisitis

Cited by 115 publications

References 24 publications

Funisitis in term pregnancy is associated with microbial invasion of the amniotic cavity and intra-amniotic inflammation

Funisitis in term pregnancy is associated with microbial invasion of the amniotic cavity and intra-amniotic inflammation

Proteomic Biomarkers of Intra-amniotic Inflammation: Relationship with Funisitis and Early-onset Sepsis in the Premature Neonate

The Antenatal Causes of Cerebral Palsy – Genetic and Viral Associations

Contact Info

Product

Resources

About