Inflammatory Biomarker Profiles in Very Preterm Infants within the Context of Preeclampsia, Chorioamnionitis, and Clinically Diagnosed Postnatal Infection

Jordan T. Ewald; Baiba Steinbrekera; Jennifer R. Bermick; Donna A. Santillan; Tarah T. Colaizy; Mark K. Santillan; Robert D. Roghair

doi:10.3390/pediatric15030044

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Inflammatory Biomarker Profiles in Very Preterm Infants within the Context of Preeclampsia, Chorioamnionitis, and Clinically Diagnosed Postnatal Infection

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Inflammatory Biomarker Profiles in Very Preterm Infants within the Context of Preeclampsia, Chorioamnionitis, and Clinically Diagnosed Postnatal Infection

Jordan T. Ewald, Baiba Steinbrekera, Jennifer R. Bermick, Donna A. Santillan, Tarah T. Colaizy, Mark K. Santillan and Robert D. Roghair

Pediatric reports, Vol.15(3), pp.483-493

08/10/2023

DOI: 10.3390/pediatric15030044

PMCID: PMC10443264

PMID: 37606448

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Abstract

Preterm delivery can be precipitated by preeclampsia or infection, and preterm infants are at heightened risk of postnatal infection. Little is known about the ontogeny of inflammatory biomarkers in extremely preterm infants. We hypothesized that suspected prenatal infection (clinical chorioamnionitis or spontaneous preterm labor) and clinically diagnosed postnatal infection would be associated with unique biomarker signatures, and those patterns would be influenced by the degree of prematurity. Venous blood was collected daily for the first week and weekly for up to 14 additional weeks from 142 neonates born at 22–32 weeks gestation. A custom array was utilized to measure monocyte chemoattractant protein-1 (MCP-1) and interleukin-6 (IL-6). C-reactive protein (CRP) levels were obtained from the electronic medical record. Independent of gestational age, MCP-1 was significantly increased (p < 0.001) in association with maternal preeclampsia, but MCP-1 was decreased (p < 0.01), and CRP was increased (p < 0.01) in the presence of chorioamnionitis with funisitis. IL-6 and CRP were both increased in infants diagnosed with postnatal infection, with peak levels observed on days 2 and 3, respectively. In conclusion, suspected prenatal and postnatal infections and non-infectious complications of pregnancy are associated with unique biomarker profiles, independent of gestational age, including over a 2-fold increase in MCP-1 among newborns of mothers with preeclampsia. Further, in those clinically diagnosed with a postnatal infection in the absence of antenatal infection concerns, IL-6 increases before CRP, emphasizing a potential role for expanded biomarker screening if antibiotics are initially avoided in infants delivered for maternal indications.

Details

Title: Subtitle: Inflammatory Biomarker Profiles in Very Preterm Infants within the Context of Preeclampsia, Chorioamnionitis, and Clinically Diagnosed Postnatal Infection
Creators: Jordan T. Ewald - University of Iowa
Baiba Steinbrekera - University of Sioux Falls
Jennifer R. Bermick - University of Iowa
Donna A. Santillan - University of Iowa
Tarah T. Colaizy - University of Iowa
Mark K. Santillan - University of Iowa
Robert D. Roghair - University of Iowa
Resource Type: Journal article
Publication Details: Pediatric reports, Vol.15(3), pp.483-493
DOI: 10.3390/pediatric15030044
PMID: 37606448
PMCID: PMC10443264
NLM abbreviation: Pediatr Rep
ISSN: 2036-7503
eISSN: 2036-7503
Grant note: name: Children’s Miracle Network; DOI: 10.13039/100006108, name: National Center for Advancing Translational Sciences, award: UL1TR002537
Language: English
Date published: 08/10/2023
Academic Unit: Stead Family Department of Pediatrics; Obstetrics and Gynecology; Neonatology
Record Identifier: 9984455540002771

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