Inflammation at Birth is Associated With Subnormal Development in Very Preterm Infants

• Published in: Pediatric research Vol. 64; no. 2; pp. 183 - 188
• Main Authors: Hansen-Pupp, Ingrid, Hallin, Anne-Li, Hellström-Westas, Lena, Cilio, Corrado, Berg, Ann-Cathrine, Stjernqvist, Karin, Fellman, Vineta, Ley, David
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.08.2008; Lippincott Williams & Wilkins
• Subjects: Biological and medical sciences; Cerebral Palsy - epidemiology; Child Development; Child, Preschool; Clinical Medicine; clinical-investigation; Cohort Studies; Diseases of mother, fetus and pregnancy; Follow-Up Studies; General aspects; Gynecology. Andrology. Obstetrics; Humans; Infant, Newborn; Infant, Premature - blood; Infant, Premature - growth & development; Inflammation - blood; Inflammation - complications; Interleukin-6 - blood; Interleukin-8 - blood; Klinisk medicin; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Outcome Assessment (Health Care); Pediatric Surgery; Pediatrics; Pediatrik; Pregnancy. Fetus. Placenta; Psychomotor Disorders - epidemiology; Risk Factors; Single-Blind Method; Tumor Necrosis Factor-alpha - blood; Human; Premature; Pediatrics; Pregnancy disorders; Premature delivery; Infant; Inflammation; Birth; Very low birthweight; Newborn diseases; Association; Prematurity; Development
• ISSN: 0031-3998; 1530-0447; 1530-0447
• DOI: 10.1203/PDR.0b013e318176144d

Preterm birth carries a risk for impaired developmental outcome. We have previously described an association between increased levels of proinflammatory cytokines during the first 72 postnatal hours and cerebral damage as detected by ultrasound in a cohort of 74 very preterm infants. Sixty-seven of 71 surviving children with a mean gestational age of 27.1 (2.0) wk were examined at 2 y corrected age with a standardized neurologic examination and with Bayley Scales of Infant Development. We hypothesized that proinflammatory cytokine concentrations at or shortly after birth would be associated with an adverse developmental outcome. Increased concentrations of TNF-α in cord blood odds ratio (95% confidence interval) 3.3 (1.1–10.2), p = 0.013 and at 6 h 7.8 (0.9–71.8), p = 0.015 and of IL-6 in cord blood 1.7 (1.0–2.9), p = 0.048 were associated with psychomotor developmental index <85. Increased concentrations of TNF-α in cord blood odds ratio (95% confidence interval) 3.6 (1.002–12.8), p = 0.044 and of IL-8 in cord blood 3.5 (1.2–10.6), p = 0.023 were associated with cerebral palsy. Associations of TNF-α and IL-8 in cord blood with the respective outcome measures remained significant after adjustment for other clinical variables. Proinflammation at birth is associated with impaired functional outcome at 2 y of corrected age in children with very preterm birth.