Amniotic fluid inflammatory cytokines (interleukin-6, interleukin-1β, and tumor necrosis factor-α), neonatal brain white matter lesions, and cerebral palsy☆,☆☆,★,★★
Section snippets
Study design
A retrospective cohort study was carried out to examine the relationship between the amniotic fluid concentrations of TNF-α, IL-1β, IL-6, and IL-1 receptor antagonist and the risk for development of brain white matter lesions. The cohort consisted of women who were admitted to Seoul National University Hospital between January 1993 and May 1995 with preterm labor, preterm premature rupture of membranes, or pregnancy-induced hypertension and who met the following criteria: (1) preterm singleton
Clinical characteristics of patients with white matter lesions
Ninety-six women met the study criteria, and 23 (24%) of their newborns had brain white matter lesions. Cystic lesions were present in 15 cases and periventricular white matter tissue loss was present in eight cases. Two cases were excluded from further analysis because the volume of amniotic fluid was insufficient to assay all the cytokines under study. Neither of these newborns had white matter lesions.
The clinical characteristics of the study population stratified according to the presence
Comment
Strong evidence supports a causal relationship between ascending intrauterine infection, the production of inflammatory cytokines by intrauterine tissues, and preterm labor and delivery.3 Recently Leviton11 has proposed that the inflammatory cytokines released during the course of intrauterine infection (i.e. IL-1, TNF-α) are also responsible for the brain white matter damage observed in preterm infants in whom cerebral palsy subsequently develops. The results of the current study support this
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Cited by (0)
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From the Departments of Obstetrics and Gynecology,a Pediatrics,b and Radiology,c College of Medicine, Seoul National University, and the Perinatology Research Branch, National Institute of Child Health and Human Development.d
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Supported by grant No. 03-95-010 from the Seoul National University Research Fund and grant No. HMP-96-M-2-0020 from the '96 Good Health R & D Project, Ministry of Health and Welfare, Republic of Korea.
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Reprint requests: Bo Hyun Yoon, MD, PhD, Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, 110-744, Korea.
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