Umbilical Cord Serum Interleukin-6, C-Reactive Protein, and Myeloperoxidase Concentrations at Birth and Association with Neonatal Morbidities and Long-Term Neurodevelopmental Outcomes
Year: 2013
Type: article
Abstract: OBJECTIVE: The aim of the study is to determine if umbilical cord serum concentrations of interleukin-6 (IL-6), C-reactive protein (CRP), and myeloperoxidase (MPO), in pregnancies at risk for preterm birth (PTB), are associated with neonatal morbidities and/or altered neurodevelopmental outcomes in the children. STUDY DESIGN: Umbilical cord serum samples were collected at birth from 400 newborns delivered within a multicenter randomized controlled trial of repeated versus single course of antenatal corticosteroids (ACs), in women at increased risk for PTB. Newborns were followed through discharge and were evaluated between 36 and 42 months corrected age with neurological examination and Bayley Scales of Infant Development. Umbilical cord serum concentrations of IL-6, CRP, and MPO were determined using enzyme-linked immunoassays. Multivariate logistic regression analyses explored the relationship between umbilical cord serum IL-6, CRP, and MPO levels, adverse newborn outcomes, and PTB < 32 weeks of gestational age (GA). RESULTS: Univariate analysis revealed that umbilical cord IL-6 above the 75th percentile was associated with increased respiratory distress syndrome (RDS) and chronic lung disease (CLD), but not with necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), or neonatal sepsis; however, this association was not significant after adjusting for GA at delivery and treatment group. No significant associations between CRP or MPO and RDS, CLD, NEC, sepsis, or IVH were evident. Regression analysis revealed that CRP above the 75th percentile was associated with a decreased risk of CLD (odds ratio, 0.10; 95% confidence interval, 0.02-0.41). No associations between umbilical cord IL-6, CRP, or MPO and MDI < 70 or PDI < 70 were evident. Umbilical cord serum concentrations of IL-6, CRP, and MPO, above the 75th percentile, were associated with more frequent PTB < 32 weeks of GA. CONCLUSION: Elevated umbilical cord serum concentration of CRP is associated with reduced risk for CLD even after adjusting for GA at delivery. Occurrence of levels > 75th percentile of IL-6, CRP, and MPO in umbilical cord serum was associated with PTB < 32 weeks of GA. Elevated umbilical cord serum concentrations of IL-6, CRP, and MPO at birth were not associated with poor neurodevelopmental outcomes.
Source: American Journal of Perinatology
Institutions: National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, George Washington University, The Ohio State University, Northwestern University, The University of Texas Southwestern Medical Center, Wake Forest University Health Sciences, Wake Forest University, University of Pittsburgh, MetroHealth Medical Center, Case Western Reserve University, University of North Carolina at Chapel Hill, University of Miami, The University of Texas Health Science Center at Houston, Brown University, University of Alabama at Birmingham, University of Tennessee Health Science Center, Wayne State University
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1216570417, General Clinical Research Center, Maternal Fetal Medicine Network: Data Coordinating Cent*, G1882602020, Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network, Maternal Fetal Medicine Units Network, MULTICENTER NETWORK OF MATERNAL-FETAL MEDICINE UNITS, G2254024324, NICHD Maternal Fetal Medicine Units Network, G2594613454, NICHD Maternal-Fetal Medicine Units (MFMU) Network, G284963502, G2925552923, G29782494, NICHD Maternal Fetal Medicine Units Network, G3681478966, Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network, Cooperative Multicenter Maternal Fetal Medicine Units Networks, G3786447104, G3875946430, G4027080872, G4189700973, Co-Operative Multicenter Trials in Obstetrics & Maternal Fetal Medicine, Data Coord Ctr-NICHD Cooperative Multicenter Maternal Medicine Units Research Net, MULTICENTER NETWORK OF MATERNAL-FETAL MEDICINE UNITS, MULTICENTER NETWORK OF MATERNAL-FETAL MEDICINE UNITS, Multicenter Network of Maternal Fetal Medicine Units, G4657398957, G50908112, Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network (U10), G6657596466, G673807916, Brown/WIH Eunice Kennedy Shriver NICHD MFM Units Network Site, MULTICENTER NETWORK OF MATERNAL-FETAL MEDICINE UNITS, Maternal Fetal Medicine Network, Carolina Population Center, NICHD Materal Fetal Medicine Units Network, MULTICENTER NETWORK OF MATERNAL-FETAL MEDICINE UNITS, UofU Maternal-Fetal Medicine Units (MFMU) Network: Clinical Centers, NICHD Maternal-Fetal Medicine Units (MFMU) Network: Data CoordinatingCenter, Brown University/Women & Infants Hospital of Rhode Island (WIH) Center Application for the Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network, Maternal Fetal Medicine Units Network - Northwestern Study Center, Maternal-Fetal Medicine Units (MFMU) Network, Case Western Reserve University Center of the NICHD MFMU Network, Columbia University Maternal-Fetal Medicine Units Network Clinical Center, NICHD maternal fetal medicine units network, UNC MFMU: Advancing Perinatal Health via Definitive, Multi-Site Clinical Studies, Eunice Kennedy Shriver NICHD Maternal-Fetal Medicine Units (MFMU) Network (UG1), G922324195
OpenAlex ID: W2075099713