Blood Cytokines during the Perinatal Period in Very Preterm Infants: Relationship of Inflammatory Response and Bronchopulmonary Dysplasia

Objective To evaluate the influence of chorioamnionitis (CA) on plasma cytokines and the cytokine-associated risk of bronchopulmonary dysplasia (BPD) during the perinatal period. Study design Eleven cytokines from 128 very low gestational age infants were analyzed from cord blood and from plasma at ages I day and 7 days after birth. The diagnosis of CA was based on histology of the placenta, fetal membranes,and umbilical cord. Neonatal risk factors were recorded. Results In the 48 infants born with CA, high concentrations of inflammatory cytokines in cord blood decreased during the first postnatal day. Inflammatory cytokines in cord blood was associated with the severity of CA. At 1 day after birth, the concentration of interleukin (IL)-8 predicted the risk of BPD. For the 75 infants born without CA, cytokine concentrations increased after birth. For the 128 infants born with or without CA, at I day after birth, the concentrations of IL-8, granulocyte colony-stimulating factor. and anti-inflammatory IL-10 were associated with the risk of BPD, after adjustment for the duration of gestation and severity of respiratory distress during the first day. Conclusions In infants exposed to CA, insufficient inhibition of high fetal inflammatory cytokine response shortly afterbirth may increase the risk of BPD. (J Pediatr 2009,154:39-43)