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Fetal inflammatory response is positively correlated with the progress of inflammation in chorionic plate

Authors
Oh, Jeong-WonPark, Chan-WookMoon, Kyung ChulPark, Joong ShinJun, Jong Kwan
Issue Date
Aug-2020
Publisher
W. B. Saunders Co., Ltd.
Keywords
FIRS; Fetal inflammatory response; Chorionic plate inflammation; Preterm labor; Preterm-PROM
Citation
Placenta, v.97, pp 6 - 17
Pages
12
Journal Title
Placenta
Volume
97
Start Page
6
End Page
17
URI
https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/19474
DOI
10.1016/j.placenta.2020.05.010
ISSN
0143-4004
1532-3102
Abstract
Introduction: No information exists about the relationship among the progress of inflammation in chorionic-plate, fetal inflammatory response (FIR), funisitis, amnionitis and early-onset neonatal sepsis (EONS) in patients with either preterm labor or preterm premature rupture of membranes (preterm-PROM). The objective of current study is to examine this issue. Methods: Study population included 247 singleton preterm gestations (21.6 weeks <= gestational age at delivery <= 36 weeks) who had either preterm-labor or preterm-PROM with acute placental inflammation. We examined the intensity of FIR, and the frequency of fetal inflammatory response syndrome (FIRS), funisitis, amnionitis and proven or suspected EONS according to the progress of inflammation in chorionic-plate. The intensity of FIR was measured with umbilical cord plasma (UCP)-CRP concentration (ng/ml) at birth, and FIRS was defined as an elevated UCP-CRP concentration (>= 200 ng/ml). The progress of inflammation in chorionic-plate was divided with a slight modification from previously reported-criteria as follows: stage-0, inflammation-free chorionicplate; stage-1, inflammation restricted to subchorionic fibrin (SCF); stage-2, inflammation in the connective tissue (CT) of chorionic-plate without chorionic vasculitis; stage-3, chorionic vasculitis. Results: 1) Stage-0, stage-1, stage-2 and stage-3 of inflammation in chorionic-plate were present in 36.8% (91/247), 29.6% (73/247), 25.5% (63/247), and 8.1% (20/247) of cases; 2) UCP-CRP concentration at birth was significantly and positively correlated with the progress of inflammation in chorionic-plate (Spearman's rank correlation test, P<.000001, gamma = 0.391 and Kruskal-Wallis test, P<.001); 3) Moreover, FIRS, funisitis, amnionitis, and EONS were significantly more frequent as a function of the progress of inflammation in chorionic-plate. Discussion: The intensity of FIR and the frequency of FIRS were positively correlated with the progress of inflammation in chorionic-plate in patients with either PTL or preterm-PROM. This suggests chorionic-plate may be an independent compartment for the analysis of inflammation.
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