The antibiotic treatment of PPROM study: systemic maternal and fetal markers and perinatal outcomes.
The antibiotic treatment of PPROM study: systemic maternal and fetal markers and perinatal outcomes.
Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
CONCLUSION: Umbilical cord blood cytokine values are higher than maternal levels, suggesting significant fetal/placental contribution. Maternal and umbilical cord cytokine levels are not adequately predictive to be used clinically. Copyright 2012 Mosby, Inc. All rights reserved. OBJECTIVE: We sought to correlate maternal and cord blood cytokine and intercellular adhesion molecule-1 levels with antibiotic exposure and perinatal outcomes after conservatively managed preterm premature rupture of the membranes. RESULTS: Cord blood IL-6 and G-CSF were higher than maternal levels. Antibiotic treatment lowered only maternal G-CSF (P = .01). Elevated maternal cytokine levels were associated with delivery within 7 days and with development of chorioamnionitis. All umbilical cord blood markers were increased with amnionitis (P <= .01 for each). No maternal marker was associated with neonatal morbidities. Cord G-CSF and IL-6 were increased with neonatal sepsis within 72 hours of birth (P = .004 for both), and with composite neonatal morbidity (P = .001 and .002, respectively). Maternal and umbilical cord cytokine levels demonstrated low predictive values for perinatal outcomes. STUDY DESIGN: Conservatively managed women with preterm premature rupture of the membranes at 24-32 weeks had blood sampling at randomization (n = 222) and delivery (n = 121). Plasma from these, and umbilical cord blood (n = 196), was stored at -70C. Interleukin (IL)-6, IL-10, granulocyte colony-stimulating factor (G-CSF), tumor necrosis factor-, and intercellular adhesion molecule-1 levels were assessed for associations with antibiotic treatment, latency, amnionitis, neonatal sepsis, pneumonia, and composite neonatal morbidity.
English
0002-9378
*Cytokines/bl [Blood]
*Fetal Blood
*Fetal Membranes, Premature Rupture/bl [Blood]
*Intercellular Adhesion Molecule-1/bl [Blood]
Adult
Amoxicillin/tu [Therapeutic Use]
Ampicillin/tu [Therapeutic Use]
Anti-Bacterial Agents/tu [Therapeutic Use]
Erythromycin/tu [Therapeutic Use]
Female
Fetal Membranes, Premature Rupture/dt [Drug Therapy]
Humans
Infant, Newborn
Pregnancy
Pregnancy Outcome
Randomized Controlled Trials as Topic
MedStar Health Research Institute
Journal Article
Research Support, N.I.H., Extramural
Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
CONCLUSION: Umbilical cord blood cytokine values are higher than maternal levels, suggesting significant fetal/placental contribution. Maternal and umbilical cord cytokine levels are not adequately predictive to be used clinically. Copyright 2012 Mosby, Inc. All rights reserved. OBJECTIVE: We sought to correlate maternal and cord blood cytokine and intercellular adhesion molecule-1 levels with antibiotic exposure and perinatal outcomes after conservatively managed preterm premature rupture of the membranes. RESULTS: Cord blood IL-6 and G-CSF were higher than maternal levels. Antibiotic treatment lowered only maternal G-CSF (P = .01). Elevated maternal cytokine levels were associated with delivery within 7 days and with development of chorioamnionitis. All umbilical cord blood markers were increased with amnionitis (P <= .01 for each). No maternal marker was associated with neonatal morbidities. Cord G-CSF and IL-6 were increased with neonatal sepsis within 72 hours of birth (P = .004 for both), and with composite neonatal morbidity (P = .001 and .002, respectively). Maternal and umbilical cord cytokine levels demonstrated low predictive values for perinatal outcomes. STUDY DESIGN: Conservatively managed women with preterm premature rupture of the membranes at 24-32 weeks had blood sampling at randomization (n = 222) and delivery (n = 121). Plasma from these, and umbilical cord blood (n = 196), was stored at -70C. Interleukin (IL)-6, IL-10, granulocyte colony-stimulating factor (G-CSF), tumor necrosis factor-, and intercellular adhesion molecule-1 levels were assessed for associations with antibiotic treatment, latency, amnionitis, neonatal sepsis, pneumonia, and composite neonatal morbidity.
English
0002-9378
*Cytokines/bl [Blood]
*Fetal Blood
*Fetal Membranes, Premature Rupture/bl [Blood]
*Intercellular Adhesion Molecule-1/bl [Blood]
Adult
Amoxicillin/tu [Therapeutic Use]
Ampicillin/tu [Therapeutic Use]
Anti-Bacterial Agents/tu [Therapeutic Use]
Erythromycin/tu [Therapeutic Use]
Female
Fetal Membranes, Premature Rupture/dt [Drug Therapy]
Humans
Infant, Newborn
Pregnancy
Pregnancy Outcome
Randomized Controlled Trials as Topic
MedStar Health Research Institute
Journal Article
Research Support, N.I.H., Extramural