Fetal but not Maternal Serum Cytokine Levels Correlate with Histologic Acute Placental Inflammation

Carolyn M. Salafia; David M. Sherer; Catherine Y. Spong; Sean Lencki; Gary S. Eglinton; Vinita Parkash; Edith Marley; Janice M. Lage

doi:10.1055/s-2007-994172

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 1997; 14(7): 419-422
DOI: 10.1055/s-2007-994172

ORIGINAL ARTICLE

Fetal but not Maternal Serum Cytokine Levels Correlate with Histologic Acute Placental Inflammation

Carolyn M. Salafia¹ ^, ² ^, ⁴ , David M. Sherer¹ ^, ³ , Catherine Y. Spong¹ ^, ³ , Sean Lencki³ , Gary S. Eglinton³ , Vinita Parkash⁵ , Edith Marley² , Janice M. Lage²

¹Perinatal Research Facility, Georgetown University Medical Center, Washington, DC
²Department of Pathology, Georgetown University Medical Center, Washington, DC
³Department of Obstetrics and Gynecology, Georgetown University Medical Center, Washington, DC
⁴Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
⁵Department of Pathology, Yale University School of Medicine, New Haven, Connecticut

Abstract

ABSTRACT

Our objective was to determine if placental histologic acute inflammation is related to maternal and fetal serum cytokine levels in preterm labor, using a data set previously constructed blinded to histopathologic information. To this goal in 1992, 32 consecutive patients at 20-36 weeks with progressive labor and tocolytic failure were recruited. Maternal serum sampled during the active phase of labor, and fetal (umbilical vein) serum were assayed by ELISA for levels of soluble interleukin-1 β (IL-1β), soluble interleukin-2 receptor (IL-2 R), and interleukin 6 (IL-6) (T-Cell Diagnostics). Acute placental inflammation was scored by two groups blinded to clinical data, and the average scores analyzed for relationships to serum cytokine levels. Weighted kappa values, reflecting interobserver agreement in scoring of acute inflammation, were: amnion 0.84; choriodecidua 0.84; umbilical cord 0.85; and chorionic plate 0.73. Fetal levels of IL-1β and IL-2 R were higher with grade 3-4 acute amnionitis than with grades 0-2 (p = 0.022 and p = 0.023). Fetal levels of all three cytokines were higher in grade 3-4 umbilical vasculitis (IL-1β p = 0.008, IL-2 R p = 0.01, and IL-6 p = 0.03). In contrast, maternal serum cytokine levels were not associated with presence or severity of histologic evidence of acute placental inflammation. Histologic acute inflammation was not related to duration of labor, interval from membrane rupture to delivery, and presence or duration of antibiotic therapy. We conclude that fetal serum, but not maternal serum cytokine levels, are correlated with histologic evidence of acute placental inflammation, and may reflect a predominant placental origin of the cytokines.

Keywords

Acute ascending infection - placental pathology - interleukins - maternal serum - fetal serum

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