Author/Editor     Štucin-Gantar, Irena
Title     Vloga prenatalnega vnetja pri nastanku bronhopulmonalne displazije
Translated title     The role of the prenatal inflammation in the development of bronchopulmonary dysplasia
Type     monografija
Place     Ljubljana
Publisher     Univerza v Ljubljani, Medicinska fakulteta
Publication year     2004
Volume     str. 98
Language     slo
Abstract     Objective. Traditionally, bronchopulmonary dysplasia (BPD) was seen to be the consequence of longterm artifcial ventilation and of high oxygen concentration treatment required by premature neonates because of respiratory distress syndrome. Studies on animals have shown that chorioamnionitis stops the alveolarisation of the fetal lungs. Decreased alveolarisation can lead to extended dependence on artificial ventilation and on long-term oxygen treatment BPD even without artificial ventilation. The purpose of this study was to test the hypothesis that prenatal infection (chorioamnionitis) and prenatal inflammation (IL-6 and IL-8 in the umbilical cord blood) increase risk for development of BPD in neonates born before 30 weeks of gestational age. Study design. Infants delivered at less than 3D completed weeks' gestation in the Ljubljana Maternity hospital during the period from September 1st, 2000 to June 30th, 2002 were induded in the study. Inflammation was evaluated with measurement of concentration of IL-6 and IL-8 in the umbilical cord blood and infection with histological examination of placenta. The IL-6 and IL-8 were measured with a specific immunoassay. From neonates who needed artificial ventilation, tracheal aspirates were taken before and after treatment with exogenous surfactant, on the third day and then every 7 days until day 28 or until extubation. BPD was defined as any oxygen requirment at 36 weeks postmenstrual age. Univariate analysis was conducted with Mann-Whitney U test or chi2 test as appropriate. Logistic regression was conducted for multivariate analysis. Receiver operating charaderistic curves were constructed to describe relationship between the sensitivity and false positive rate for different levels of IL-6 or IL-8 in the predidion of BPD. Prenatal and postnatal risk factors for BPD were established using a univariate analysis and finally entered into multivariate analysis for the final conclusion. (Abstract truncated at 2000 characters).
Descriptors     BRONCHOPULMONARY DYSPLASIA
CHORIOAMNIONITIS
INTERLEUKIN-6
INTERLEUKIN-8
PLACENTA
RESPIRATION, ARTIFICIAL
RISK FACTORS
RESPIRATORY DISTRESS SYNDROME
INTENSIVE CARE UNITS, NEONATAL
SEPSIS
ROC CURVE
INFANT, NEWBORN