Journal
PEDIATRIC RESEARCH
Volume 61, Issue 3, Pages 318-324Publisher
INT PEDIATRIC RESEARCH FOUNDATION, INC
DOI: 10.1203/01.pdr.0000252439.48564.37
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Funding
- NHLBI NIH HHS [K08 HL 074195] Funding Source: Medline
- NICHD NIH HHS [R03 HD 50249, R01 HD047321-02, R01 HD 047321, R01 HD047321-01, K12 HD 047018, R01 HD047321, R01 HD047321-03] Funding Source: Medline
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Our goal was to determine the relationship between 4 amniotic fluid (AF) proteomic biomarkers (human neutrophil defensins 2 and 1, calgranulins C and A) characteristic of intra-amniotic inflammation, and funisitis and early-onset sepsis in premature neonates. The mass restricted (MR) score was generated from AF obtained from women in preterm labor (n = 123). The MR score ranged from 0-4 (none to all biomarkers present). Funisitis was graded histologically and interpreted in relation to the MR scores. Neonates (n = 97) were evaluated for early-onset sepsis. There was significant correlation between the severity of AF inflammation and the presence (53/123) and grades of funisitis (p < 0.001). Funisitis occurred independently of the amniocentesis-to-delivery interval or status of the membranes and was best predicted by an MR score 3-4 and an earlier gestational age (GA) at delivery. Neonates born to women with an MR score 3-4 had an increased incidence of suspected/confirmed sepsis, even after adjusting for GA at birth. Calgranulin C had the highest association with clinically significant funisitis, while calgranulin A had the strongest association with early-onset sepsis. To conclude, AF proteomic analysis shows that women with MR scores 3-4 are more likely to have histologic funisitis, and deliver neonates with early-onset sepsis.
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