Chorioamnionitis and Ontogeny of Circulating Prostaglandin and Thromboxane in Preterm Infants

ABSTRACT

Our objective was to determine the effect of chorioamnionitis on plasma prostaglandin E2 (PGE2) and thromboxane B2 (TxB2) during the first week in preterm infants. Plasma PGE2 and TxB2 were measured at 1, 3, and 7 days of age in preterm infants (birth weights 501 to 1500 g), with (n = 26) and without (n = 22) chorioamnionitis. Infants with maternal chorioamnionitis had significantly lower mean gestational age (p = 0.0001) and birth weight (p = 0.03) and a marginally higher rate of bronchopulmonary dysplasia (37% versus 12.5, p = 0.05), a result that may be related to the lower mean gestational age. Plasma PGE2 and TxB2 varied widely, more so on the first day but did not significantly differ between the two groups. TxB2 was lower among infants who died or developed morbidities. Circulating PGE2 and TxB2 concentrations in preterm infants in the first week vary considerably, are relatively unaltered by chorioamnionitis, and are lower in association with mortality and clinical morbidities. Further research on their role in the causation of adverse neonatal outcomes is necessary.

Prostaglandin - thromboxane - preterm - chorioamnionitis

REFERENCES

• 1 Challis J R, Sloboda D M, Alfaidy N et al.. Prostaglandins and mechanisms of preterm birth.  Reproduction. 2002;  124 1-17
• 2 Agostiniani R, Mariotti P, Cataldi L et al.. Role of renal PGE2 in the adaptation from foetal to extrauterine life in term and preterm infants.  Prostaglandins Leukot Essent Fatty Acids. 2002;  67 373-377
• 3 Chemtob S, Li D Y, Abran D et al.. The role of prostaglandin receptors in regulating cerebral blood flow in the perinatal period.  Acta Paediatr. 1996;  85 517-524
• 4 Seyberth H W, Kuhl P G. The role of eicosanoids in paediatrics.  Eur J Pediatr. 1988;  147 341-349
• 5 Seyberth H W, Leonhardt A, Tonshoff B et al.. Prostanoids in paediatric kidney diseases.  Pediatr Nephrol. 1991;  5 639-649
• 6 Dammann O, Leviton A. Maternal intrauterine infection, cytokines, and brain damage in the preterm newborn.  Pediatr Res. 1997;  42 1-8
• 7 Gomez R, Romero R, Ghezzi F et al.. The fetal inflammatory response syndrome.  Am J Obstet Gynecol. 1998;  179 194-202
• 8 Yoon B H, Romero R, Jun J K et al.. Amniotic fluid cytokines (interleukin-6, tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-8) and the risk for the development of bronchopulmonary dysplasia.  Am J Obstet Gynecol. 1997;  177 825-830
• 9 Curley A E, Sweet D G, MacMahon K J et al.. Chorioamnionitis increases matrix metalloproteinase-8 concentrations in bronchoalveolar lavage fluid from preterm babies.  Arch Dis Child Fetal Neonatal Ed. 2004;  89 F61-F64
• 10 Mitchell M D, Bibby J G, Hicks B R et al.. Thromboxane B2 and human parturition: concentrations in the plasma and production in vitro.  J Endocrinol. 1978;  78 435-441
• 11 Varvarigou A, Bardin C L, Beharry K et al.. Early ibuprofen administration to prevent patent ductus arteriosus in premature newborn infants.  JAMA. 1996;  275 539-544
• 12 Viscardi R M, Muhumuza C K, Rodriguez A et al.. Inflammatory markers in intrauterine and fetal blood and cerebrospinal fluid compartments are associated with adverse pulmonary and neurologic outcomes in preterm infants.  Pediatr Res. 2004;  55 1009-1017
• 13 Watterberg K L, Demers L M, Scott S M et al.. Chorioamnionitis and early lung inflammation in infants in whom bronchopulmonary dysplasia develops.  Pediatrics. 1996;  97 210-215
• 14 Gupta M, Mestan K K, Martin C R et al.. Impact of clinical and histologic correlates of maternal and fetal inflammatory response on gestational age in preterm births.  J Matern Fetal Neonatal Med. 2007;  20 39-46
• 15 Yang S Y, Gao Z X. Determination and clinical significance of plasma levels of prostaglandins in patients with acute brain injury.  Surg Neurol. 1999;  52 238-245
• 16 Lopez-Herce J, Codoceo R, Delgado M A et al.. Plasma and gastric juice levels of prostaglandins in critically ill children.  J Pediatr Gastroenterol Nutr. 1992;  14 279-282
• 17 Sood B G, Delaney-Black V, Glibetic M et al.. PGE2/TXB2 imbalance in neonatal hypoxemic respiratory failure.  Acta Paediatr. 2007;  96 669-673
• 18 Clyman R I, Brett C, Mauray F. Circulating prostaglandin E2 concentrations and incidence of patent ductus arteriosus in preterm infants with respiratory distress syndrome.  Pediatrics. 1980;  66 725-729
• 19 Kopelman A E, Dombroski D, Engelke S C et al.. Plasma prostaglandin E2 and F2 alpha in preterm infants: association with respiratory distress syndrome and patent ductus arteriosus.  Prostaglandins Leukot Med. 1983;  10 423-431
• 20 Hammerman C, Zaia W, Berger S et al.. Prostaglandin levels: predictors of indomethacin responsiveness.  Pediatr Cardiol. 1986;  7 61-65
• 21 Cho S, Beharry K D, Valencia A M et al.. Maternal and feto-placental prostanoid responses to a single course of antenatal betamethasone.  Prostaglandins Other Lipid Mediat. 2005;  78 139-159
• 22 Huang H C, Wang C L, Huang L T et al.. Association of cord blood cytokines with prematurity and cerebral palsy.  Early Hum Dev. 2004;  77 29-36
• 23 Redline R W, Wilson-Costello D, Hack M. Placental and other perinatal risk factors for chronic lung disease in very low birth weight infants.  Pediatr Res. 2002;  52 713-719
• 24 Le Guennec J C, Lauziere M, Black R et al.. Effects of indomethacin on prostaglandin E2 and thromboxane B2 contents of tracheal lavage fluids in premature infants.  Inflammation. 1991;  15 55-59
• 25 Strasser T, Vogel M. Prostaglandin E2 in the lung lavage fluid of premature newborns before and after surgical or medical closure of a patent ductus arteriosus.  Biochim Biophys Acta. 1989;  1003 63-66
• 26 Bashakin N F, Saliaeva M V, Aksenov A N. The functional characteristics of the prostacyclin-thromboxane system in newborn infants with a history of acute and chronic intrauterine hypoxia.  Akush Ginekol (Mosk). 1993;  (6) 24-27
• 27 Nishimaki S, Seki K. An imbalance between prostacyclin and thromboxane in relation to cerebral blood flow in neonates with maternal preeclampsia.  Prostaglandins Other Lipid Mediat. 1999;  58 43-49
• 28 Leonhardt A, Kuhl P G, Schweer H et al.. Pharmacologically active levels of PGE1 in neonates with congenital heart disease.  Acta Paediatr Scand. 1989;  78 853-857
• 29 Schweer H, Meese C O, Watzer B et al.. Determination of prostaglandin E1 and its main plasma metabolites 15-keto-prostaglandin E0 and prostaglandin E0 by gas chromatography/negative ion chemical ionization triple-stage quadrupole mass spectrometry.  Biol Mass Spectrom. 1994;  23 165-170