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Inflammatory Biomarker Profiles in Very Preterm Infants within the Context of Preeclampsia, Chorioamnionitis and Clinically Diagnosed Postnatal Infection
Ewald, J.T.; Steinbrekera, B.; Bermick, J.R.; Santillan, D.A.; Colaizy, T.T.; Santillan, M.K.; Roghair, R.D. Inflammatory Biomarker Profiles in Very Preterm Infants within the Context of Preeclampsia, Chorioamnionitis, and Clinically Diagnosed Postnatal Infection. Pediatr. Rep.2023, 15, 483-493.
Ewald, J.T.; Steinbrekera, B.; Bermick, J.R.; Santillan, D.A.; Colaizy, T.T.; Santillan, M.K.; Roghair, R.D. Inflammatory Biomarker Profiles in Very Preterm Infants within the Context of Preeclampsia, Chorioamnionitis, and Clinically Diagnosed Postnatal Infection. Pediatr. Rep. 2023, 15, 483-493.
Ewald, J.T.; Steinbrekera, B.; Bermick, J.R.; Santillan, D.A.; Colaizy, T.T.; Santillan, M.K.; Roghair, R.D. Inflammatory Biomarker Profiles in Very Preterm Infants within the Context of Preeclampsia, Chorioamnionitis, and Clinically Diagnosed Postnatal Infection. Pediatr. Rep.2023, 15, 483-493.
Ewald, J.T.; Steinbrekera, B.; Bermick, J.R.; Santillan, D.A.; Colaizy, T.T.; Santillan, M.K.; Roghair, R.D. Inflammatory Biomarker Profiles in Very Preterm Infants within the Context of Preeclampsia, Chorioamnionitis, and Clinically Diagnosed Postnatal Infection. Pediatr. Rep. 2023, 15, 483-493.
Abstract
Preterm delivery can be precipitated by infection, and preterm infants are at heightened risk of postnatal infection. Little is known about the ontogeny of inflammatory biomarkers in extremely preterm infants. We hypothesized that suspected prenatal infection (chorioamnionitis or spontaneous preterm labor) and clinically diagnosed postnatal infection would be associated with unique biomarker signatures, and those patterns would be influenced by the degree of prematurity. Venous blood was collected daily for the first week and weekly for up to 14 additional weeks from 142 neonates born at 22-32 weeks gestation. A custom array was utilized to measure monocyte chemoattractant protein-1 (MCP-1) and interleukin-6 (IL-6). C-reactive protein (CRP) levels were obtained from the electronic medical record. 90 infants had suspected prenatal infection and 63 were diagnosed with postnatal infection. Independent of gestational age at delivery, MCP-1 was significantly increased (P < 0.001) in association with maternal preeclampsia, but MCP-1 was decreased (P<0.01) and CRP was increased (P<0.05) in the presence of chorioamnionitis. IL-6 and CRP were both increased in infants diagnosed with postnatal infection with peak levels observed on days 2 and 3, respectively. In conclusion, suspected prenatal and postnatal infections and non-infectious complications of pregnancy are associated with unique biomarker profiles, independent of gestational age. In those clinically diagnosed with a postnatal infection in the absence of antenatal infection concerns, IL-6 increases before CRP, emphasizing a potential role for expanded biomarker screening if antibiotics are initially avoided in infants born exclusively for maternal indications.
Medicine and Pharmacology, Pediatrics, Perinatology and Child Health
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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