The significance of fetal inflammatory response syndrome in early and later adaptation of premature infants.

PURPOSE: Intrauterine infection may induce the fetal inflammatory response syndrome (FIRS) and may cause cerebral palsy and bronchopulmonary dysplasia in newborns. The aim of the study was to evaluate the importance of FIRS for the early and later adaptation of preterms.

METHODS

Hundred and fifty-eight preterm infants, born at 22-34 weeks of gestation, were investigated at Vilnius University Children hospital in 2007-2009. The data were evaluated at the first week after birth and at 36-37 weeks of post conceptual age. The levels of IL-6, tTNF-α (total), tVEGF-A (total), aTNF-α (active) and aVEGF-A (active) were determined.

RESULTS

Correlation between IL-6 and tTNF-α from umbilical blood and the degree of respiratory distress syndrome (RDS) was found (p < 0.001). The concentration of tTNF-α >345 pg/ml and IL-6 >12.7 pg/ml was determined allowing to predict the lethal outcome.

CONCLUSIONS

The correlation between the concentration of the inflammatory markers IL-6 and tTNF-α in umbilical cord blood at 22-34 weeks of gestation and acute RDS, and the death of preterms was determined. Significant values of umbilical cord blood IL-6 and tTNF-α concentration for predicting the lethal outcome in the later adaptation of preterms were determined.