Postnatal changes of cytokines in premature infants with or without funisitis

Objective: Fetal inflammatory response syndrome (FIRS), which induces hypercytokinemia, is important for the outcomes of premature infants. It is necessary to focus on the fetal inflammatory environments. Methods: A total of 37 premature infants (gestational age <= 32 weeks) were divided into three groups: (1) 15 without chorioamnionitis (CAM) and funisitis; C(-)F(-) group, (2) 15 with CAM but without funisitis; C(+)F(-) group and (3) 7 with CAM and funisitis; C(+) F(+) group. Blood interleukin (IL)-1 beta, IL-6 and IL-8 levels were measured on day 0 (= in umbilical cord blood), 3, 7, 14, 21 and 28. Results: (1) day 0: Cord blood concentrations of IL-1 beta, IL-6 and IL-8 were significantly higher in the C(+)F(+) group than in the C(+)F(-) group and C(-)F(-) group. On the other hand, they were comparable between the C(+)F(-) group and C(-)F(-) group. (2) Days 3-28: elevated cytokines levels in the C(+)F(+) group with funisitis decreased on day 3 and later. Conclusions: We suggested that hypercytokinemia in the cord blood in premature infants were greatly related with funisitis. Diagnosis of funisitis would be important to find the premature infants who need to be managed their risk of FIRS. In addition, hypercytokinemia disappeared in a few days after birth; therefore, cord blood data analysis of cytokines and/or inflammation-related proteins concentrations is necessary to evaluate the fetal inflammatory environments in premature infants after birth.