Maternal Infection, Fetal Inflammatory Response, and Brain Damage in Very Low Birth Weight Infants View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

1999-11

AUTHORS

Alan Leviton, Nigel Paneth, M Lynne Reuss, Mervyn Susser, Elizabeth N Allred, Olaf Dammann, Karl Kuban, Linda J van Marter, Marcello Pagano, Thomas Hegyi, Mark Hiatt, Ulana Sanocka, Farrokh Shahrivar, Michael Abiri, Donald Disalvo, Peter Doubilet, Ram Kairam, Elias Kazam, Madhuri Kirpekar, David Rosenfeld, Steven Schonfeld, Jane Share, Margaret Collins, David Genest, Debra Heller, Susan Shen-Schwarz

ABSTRACT

Echolucent images (EL) of cerebral white matter, seen on cranial ultrasonographic scans of very low birth weight newborns, predict motor and cognitive limitations. We tested the hypothesis that markers of maternal and feto-placental infection were associated with risks of both early (diagnosed at a median age of 7 d) and late (median age = 21 d) EL in a multi-center cohort of 1078 infants <1500 x g. Maternal infection was indicated by fever, leukocytosis, and receipt of antibiotic; fetoplacental inflammation was indicated by the presence of fetal vasculitis (i.e. of the placental chorionic plate or the umbilical cord). The effect of membrane inflammation was also assessed. All analyses were performed separately in infants born within 1 h of membrane rupture (n = 537), or after a longer interval (n = 541), to determine whether infection markers have different effects in infants who are unlikely to have experienced ascending amniotic sac infection as a consequence of membrane rupture. Placental membrane inflammation by itself was not associated with risk of EL at any time. The risks of both early and late EL were substantially increased in infants with fetal vasculitis, but the association with early EL was found only in infants born > or =1 after membrane rupture and who had membrane inflammation (adjusted OR not calculable), whereas the association of fetal vasculitis with late EL was seen only in infants born <1 h after membrane rupture (OR = 10.8; p = 0.05). Maternal receipt of antibiotic in the 24 h just before delivery was associated with late EL only if delivery occurred <1 h after membrane rupture (OR = 6.9; p = 0.01). Indicators of maternal infection and of a fetal inflammatory response are strongly and independently associated with EL, particularly late EL. More... »

PAGES

566

Identifiers

URI

http://scigraph.springernature.com/pub.10.1203/00006450-199911000-00013

DOI

http://dx.doi.org/10.1203/00006450-199911000-00013

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1064217127

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/10541320


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