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Neutrophil defensins but not interleukin-6 in vaginal fluid after preterm premature rupture of membranes predict fetal/neonatal inflammation and infant neurological impairmentLučovnik, Miha ...Objective. To determine whether neutrophil defensins (HNP1-3) and interleukin-6 (IL-6) in vaginal fluid after preterm premature rupture of membranes predict fetal inflammatory response syndrome ... (FIRS), neurological impairment or chorioamnionitis. Design. Prospective study. Setting. Tertiary referral university hospital. Population. Forty-two patients with preterm premature rupture of membranes at <32 weeks. Methods. Levels of HNP1-3 and IL-6 were measured in vaginal fluid obtained by swabs. Mann-Whitney U-test wasused to compare HNP1-3 and IL-6 levels in groups with vs. without FIRS, infant death or neurological impairment, and chorioamnionitis (p<0.05 significant). Logistic regression was used to control for potential confounders. Diagnostic accuracies of HNP1-3 and IL-6 were determined by receiver operator characteristics analysis. Main Outcome Measures. Fetal inflammatory response syndrome was defined as neonatal inflammation within 72hours postpartum. Neurological impairment was defined as motor and/or tone abnormalities at one year of corrected age. Chorioamnionitis was diagnosed histologically. Results. Levels of HNP1-3, but not IL-6, were higher in 12 cases of FIRS (p=0.019 and p=0.256, respectively). Levels of HNP1-3, but not IL-6, were higher in 14 cases of infant death or neurological impairment (p=0.015 and p=0.100, respectively) and, when only survivors were analyzed, innine cases of neurological impairment (p=0.030 and p=0.187, respectively). Levels of HNP1-3 and IL-6 were higher in 29 cases of chorioamnionitis (p=0.005and p=0.003, respectively). The differences remained significant afteradjustment for gestational age. Levels of HNP1-3 predicted FIRS, infant death or neurological impairment and chorioamnionitis with an area under the curve of 0.75, 0.79 and 0.78, respectively. Conclusions. Elevated vaginal fluid HNP1-3 and IL-6 levels are associated with histological chorioamnionitis. (Abs. trunc. at 2000 ch.)Source: Acta obstetricia et gynecologica Scandinavica. - ISSN 0001-6349 (Vol. 90, issue 8, 2011, str. 908-916)Type of material - article, component partPublish date - 2011Language - englishCOBISS.SI-ID - 28563161
Author
Lučovnik, Miha |
Kornhauser-Cerar, Lilijana, 1958- |
Premru-Sršen, Tanja |
Gmeiner, Tanja |
Derganc, Metka
Topics
Fetal Membranes, Premature Rupture |
Neutrophils |
Interleukin-6 |
Vaginal Smears |
Infant, Newborn, Diseases |
Inflammation |
Chorioamnionitis |
Neurologic Examination |
Motor Neuron Disease |
Dystonia |
Logistic Models |
Prospective Studies |
Infant, Newborn |
Interlevkin-6 |
Nevtrofilci |
Plodove membrane, prezgodnja ruptura |
Vaginalni razmazi |
Novorojenček, bolezni |
Prospektivne študije |
Vnetje |
Motorični nevron, bolezen |
Novorojenček |
Horioamnionitis |
Nevrološka preiskava |
Distonija |
Logistični modeli
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Database name | Field | Year |
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Lučovnik, Miha | 30746 |
Kornhauser-Cerar, Lilijana, 1958- | 12176 |
Premru-Sršen, Tanja | 00789 |
Gmeiner, Tanja | 15706 |
Derganc, Metka | 02148 |
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