The Role of Inflammation and Infection in Preterm Birth

Roberto Romero; Jimmy Espinoza; Luís F. Gonçalves; Juan Pedro Kusanovic; Lara Friel; Sonia Hassan

doi:10.1055/s-2006-956773

Seminars in Reproductive Medicine, Inhaltsverzeichnis

Semin Reprod Med 2007; 25(1): 021-039
DOI: 10.1055/s-2006-956773

The Role of Inflammation and Infection in Preterm Birth

Roberto Romero¹ ^, ² , Jimmy Espinoza¹ ^, ³ , Luís F. Gonçalves¹ ^, ³ , Juan Pedro Kusanovic¹ , Lara Friel³ , Sonia Hassan¹ ^, ³

¹Perinatology Research Branch, National Instituted of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, and Detroit, Michigan
²Center for Molecular Medicine and Genetics, Wayne State University, Detroit, Michigan
³Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan

Abstract

ABSTRACT

Inflammation has been implicated in the mechanisms responsible for preterm and term parturition, as well as fetal injury. Out of all of the suspected causes of preterm labor and delivery, infection and/or inflammation is the only pathological process for which both a firm causal link with preterm birth has been established and a molecular pathophysiology defined. Inflammation has also been implicated in the mechanism of spontaneous parturition at term. Most cases of histopathological inflammation and histological chorioamnionitis, both in preterm and term labor, are sub-clinical in nature. The isolation of bacteria in the amniotic fluid, known as microbial invasion of the amniotic cavity, is a pathological finding; the frequency of which is dependent upon the clinical presentation and gestational age. This article reviews the role of inflammation in preterm and term parturition.

KEYWORDS

Preterm labor - cytokines - fetal inflammatory response syndrome - chemokines - microbial invasion of the amniotic cavity

Volltext

Referenzen

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163 Sadowsky D W, Novy M J, Witkin S S, Gravett M G. Dexamethasone or interleukin-10 blocks interleukin-1beta-induced uterine contractions in pregnant rhesus monkeys. Am J Obstet Gynecol. 2003; 188 252-263
164 Romero R, Mazor M, Tartakovsky B. Systemic administration of interleukin-1 induces preterm parturition in mice. Am J Obstet Gynecol. 1991; 165 969-971
165 Romero R, Tartakovsky B. The natural interleukin-1 receptor antagonist prevents interleukin-1-induced preterm delivery in mice. Am J Obstet Gynecol. 1992; 167 1041-1045
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169 Silver R M, Lohner S, Chen C L. Tumor necrosis factor-alpha mediates LPS-induced abortion: evidence from the LPS-resistant murine strain C3H/HeJ. J Soc Gynecol Investig. 1993; 218 (Abst)
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173 Athayde N, Edwin S S, Romero R et al.. A role for matrix metalloproteinase-9 in spontaneous rupture of the fetal membranes. Am J Obstet Gynecol. 1998; 179 1248-1253
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175 Romero R, Chaiworapongsa T, Espinoza J et al.. Fetal plasma MMP-9 concentrations are elevated in preterm premature rupture of the membranes. Am J Obstet Gynecol. 2002; 187 1125-1130
176 Osmers R GW, Adelmann-Grill B C, Rath W et al.. Biochemical events in cervical ripening dilatation during pregnancy and parturition. J Obstet Gynaecol. 1995; 21 185-194
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179 Romero R, Avila C, Santhanam U, Sehgal P B. Amniotic fluid interleukin 6 in preterm labor. Association with infection. J Clin Invest. 1990; 85 1392-1400
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181 Gomez R, Romero R, Galasso M et al.. The value of amniotic fluid interleukin-6, white blood cell count, and gram stain in the diagnosis of microbial invasion of the amniotic cavity in patients at term. Am J Reprod Immunol. 1994; 32 200-210
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186 Athayde N, Romero R, Maymon E et al.. Interleukin 16 in pregnancy, parturition, rupture of fetal membranes, and microbial invasion of the amniotic cavity. Am J Obstet Gynecol. 2000; 182 135-141
187 Pacora P, Romero R, Maymon E et al.. Participation of the novel cytokine interleukin 18 in the host response to intra-amniotic infection. Am J Obstet Gynecol. 2000; 183 1138-1143
188 Saito S, Kato Y, Ishihara Y, Ichijo M. Amniotic fluid granulocyte colony-stimulating factor in preterm and term labor. Clin Chim Acta. 1992; 208 105-109
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192 Romero R, Ceska M, Avila C et al.. Neutrophil attractant/activating peptide-1/interleukin-8 in term and preterm parturition. Am J Obstet Gynecol. 1991; 165 813-820
193 Yoon B H, Romero R, Jun J K et al.. Amniotic fluid cytokines (interleukin-6, tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-8) and the risk for the development of bronchopulmonary dysplasia. Am J Obstet Gynecol. 1997; 177 825-830
194 Ghezzi F, Gomez R, Romero R et al.. Elevated interleukin-8 concentrations in amniotic fluid of mothers whose neonates subsequently develop bronchopulmonary dysplasia. Eur J Obstet Gynecol Reprod Biol. 1998; 78 5-10
195 Esplin M S, Romero R, Chaiworapongsa T et al.. Monocyte chemotactic protein-1 is increased in the amniotic fluid of women who deliver preterm in the presence or absence of intra-amniotic infection. J Matern Fetal Neonatal Med. 2005; 17 365-373
196 Keelan J A, Yang J, Romero R J et al.. Epithelial cell-derived neutrophil-activating peptide-78 is present in fetal membranes and amniotic fluid at increased concentrations with intra-amniotic infection and preterm delivery. Biol Reprod. 2004; 70 253-259
197 Athayde N, Romero R, Maymon E et al.. A role for the novel cytokine RANTES in pregnancy and parturition. Am J Obstet Gynecol. 1999; 181 989-994
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205 Gomez R, Ghezzi F, Romero R et al.. Two thirds of human fetuses with microbial invasion of the amniotic cavity have a detectable systemic cytokine response before birth. Am J Obstet Gynecol. 1997; 176 S14
206 Yoon B H, Romero R, Kim K S et al.. A systemic fetal inflammatory response and the development of bronchopulmonary dysplasia. Am J Obstet Gynecol. 1999; 181 773-779
207 Chaiworapongsa T, Romero R, Kim J C et al.. Evidence for fetal involvement in the pathologic process of clinical chorioamnionitis. Am J Obstet Gynecol. 2002; 186 1178-1182
208 Witt A, Berger A, Gruber C J et al.. IL-8 concentrations in maternal serum, amniotic fluid and cord blood in relation to different pathogens within the amniotic cavity. J Perinat Med. 2005; 33 22-26
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211 Yoon B H, Romero R, Park J S et al.. Fetal exposure to an intra-amniotic inflammation and the development of cerebral palsy at the age of three years. Am J Obstet Gynecol. 2000; 182 675-681
212 Yoon B H, Romero R, Shim J Y et al.. C-reactive protein in umbilical cord blood: a simple and widely available clinical method to assess the risk of amniotic fluid infection and funisitis. J Matern Fetal Neonatal Med. 2003; 14 85-90
213 Sampson J E, Theve R P, Blatman R N et al.. Fetal origin of amniotic fluid polymorphonuclear leukocytes. Am J Obstet Gynecol. 1997; 176 77-81
214 Shim S S, Yoon B H, Romero R et al.. The frequency and clinical significance on intra-amniotic inflammation in patients with preterm premature rupture of the membranes. Am J Obstet Gynecol. 2003; 189 S83
215 Romero R, Athayde N, Gomez R et al.. The fetal inflammatory response syndrome is characterized by the outpouring of a potent extracellular matrix degrading enzyme into the fetal circulation. Am J Obstet Gynecol. 1998; 178 S3
216 Gomez R, Berry S, Yoon B H et al.. The hematologic profile of the fetus with systemic inflammatory response syndrome. Am J Obstet Gynecol. 1998; 178 S202
217 Berry S M, Gomez R, Athayde N et al.. The role of granulocyte colony stimulating factor in the neutrophilia observed in the fetal inflammatory response syndrome. Am J Obstet Gynecol. 1998; 178 S202
218 Gomez R, Romero R, Ghezzi F et al.. Are fetal hypoxia and acidemia causes of preterm labor and delivery?. Am J Obstet Gynecol. 1997; 176 S115
219 Baschat A A, Gembruch U, Reiss I et al.. Neonatal nucleated red blood cell counts in growth-restricted fetuses: relationship to arterial and venous Doppler studies. Am J Obstet Gynecol. 1999; 181 190-195
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223 Haeryfar S M, Berczi I. The thymus and the acute phase response. Cell Mol Biol. 2001; 47 145-156
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247 Yoon B H, Romero R, Kim C J et al.. High expression of tumor necrosis factor-alpha and interleukin-6 in periventricular leukomalacia. Am J Obstet Gynecol. 1997; 177 406-411
248 Leviton A, Dammann O, Durum S K. The adaptive immune response in neonatal cerebral white matter damage. Ann Neurol. 2005; 58 821-828
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254 Gerber S, Yih M, Vardhana S et al.. Relation between fetal interleukin-1 receptor antagonist (IL-1RA) gene polymorphism and unexplained fetal death. Am J Obstet Gynecol. 2002; 187 S58
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Roberto RomeroM.D.

Perinatology Research Branch, NICHD/NIH/DHHS Hutzel Women's Hospital - Box #4

3990 John R., Detroit, MI 48201

eMail: warfiela@mail.nih.gov