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Maternal infection, fetal inflammatory response, and brain damage in very low birth weight infants

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TLDR
Echolucent images of cerebral white matter, seen on cranial ultrasonographic scans of very low birth weight newborns, predict motor and cognitive limitations and indicators of maternal infection and of a fetal inflammatory response are strongly and independently associated with EL.
Abstract
Echolucent images (EL) of cerebral white matter, seen on cranial ultrasonographic scans of very low birth weight newborns, predict motor and cognitive limitations. We tested the hypothesis that markers of maternal and feto-placental infection were associated with risks of both early (diagnosed at a median age of 7 d) and late (median age = 21 d) EL in a multi-center cohort of 1078 infants or =1 after membrane rupture and who had membrane inflammation (adjusted OR not calculable), whereas the association of fetal vasculitis with late EL was seen only in infants born <1 h after membrane rupture (OR = 10.8; p = 0.05). Maternal receipt of antibiotic in the 24 h just before delivery was associated with late EL only if delivery occurred <1 h after membrane rupture (OR = 6.9; p = 0.01). Indicators of maternal infection and of a fetal inflammatory response are strongly and independently associated with EL, particularly late EL.

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Neurobiology of Periventricular Leukomalacia in the Premature Infant

TL;DR: New insights into the pathogenesis of PVL suggest potential preventive interventions, including avoidance of cerebral ischemia by detection of infants with impaired cerebrovascular autoregulation, and the use of maternal antibiotics or anticytokine agents to prevent toxicity from maternal/fetal infection or inflammation and cytokines.
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Chorioamnionitis as a risk factor for cerebral palsy: A meta-analysis.

TL;DR: A meta-analysis indicates that chorioamnionitis is a risk factor for both cerebral palsy and cPVL.
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The Toll-Like Receptor TLR4 Is Necessary for Lipopolysaccharide-Induced Oligodendrocyte Injury in the CNS

TL;DR: The data provide a general mechanistic link between (1) lipopolysaccharide and similar microbial molecular motifs and (2) injury to oligodendrocytes and myelin as occurs in periventricular leukomalacia and multiple sclerosis.

Chorioamnionitis as a Risk Factor for Cerebral Palsy

TL;DR: In this article, a meta-analysis indicates that chorioamnionitis is a risk factor for both cerebral palsy and cPVL in full-term infants, and a positive association was found between clinical chorioamionitis and cerebral palsys (RR, 4.7; 95% CI, 1.3-16.2).
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Amniotic Infection Syndrome: Nosology and Reproducibility of Placental Reaction Patterns

TL;DR: A complete set of the placental reaction patterns seen with amniotic fluid infection was assembled and validated in the hope that this might provide a standardized diagnostic framework useful for practicing pathologists.
References
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Journal ArticleDOI

Maternal intrauterine infection, cytokines, and brain damage in the preterm newborn

TL;DR: Unifying models postulate how proinflammatory cytokines might lead to IVH and neonatal white matter damage during prenatal maternal infection and intervene to prevent later disability in those born near the end of the second trimester.
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Maternal infection and cerebral palsy in infants of normal birth weight.

TL;DR: Intrauterine exposure to maternal infection was associated with a marked increase in risk of CP in infants of normal birth weight and was linked with low Apgar scores, other evidence of hypotension [corrected] and need for resuscitation, and neonatal seizures-signs commonly attributed to birth asphyxia.
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Amniotic fluid inflammatory cytokines (interleukin-6, interleukin-1β, and tumor necrosis factor-α), neonatal brain white matter lesions, and cerebral palsy

TL;DR: The hypothesis that inflammatory cytokines released during the course of intrauterine infection play a role in the genesis of brain white matter lesions is supported.
Journal ArticleDOI

Interleukin-6 concentrations in umbilical cord plasma are elevated in neonates with white matter lesions associated with periventricular leukomalacia

TL;DR: In this article, the authors examined the relationship between umbilical cord plasma levels of tumor necrosis factor-α, interleukin-1β, intra-cellular leukomalacia-associated lesion and the occurrence of periventricular leucomalacia in preterm neonates.
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