Am J Perinatol 2015; 32(02): 115-122
DOI: 10.1055/s-0034-1376185
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Association of Cord Serum Cytokines with Neurodevelopmental Outcomes

Michael W. Varner
1  Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah
,
Nicole E. Marshall
2  Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
,
Dwight J. Rouse
3  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
,
Kathleen A. Jablonski
4  Department of Biostatistics, George Washington University Biostatistics Center, Washington, District of Columbia
,
Kenneth J. Leveno
5  Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
,
Uma M. Reddy
6  Department of Obstetrics and Gynecology, Eunice Kennedy Shriver National Institute of Child Health and Human Development
,
Brian M. Mercer
7  Department of Obstetrics and Gynecology, Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio
8  Department of Obstetrics and Gynecology, University of Tennessee, Memphis, Tennessee
,
Jay D. Iams
9  Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio
,
Ronald J. Wapner
10  Department of Obstetrics and Gynecology, Thomas Jefferson University and Drexel University, Philadelphia, Pennsylvania
,
Yoram Sorokin
11  Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan
,
John M. Thorp
12  Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
,
Fergal D. Malone
13  Department of Obstetrics and Gynecology, Columbia University, New York, New York
,
Marshall Carpenter
14  Department of Obstetrics and Gynecology, Brown University, Providence, Rhode Island
,
Mary J. O'Sullivan
15  Department of Obstetrics and Gynecology, University of Miami, Miami, Florida
,
Alan M. Peaceman
16  Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois
,
Gary D. V. Hankins
17  Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
,
Donald J. Dudley
18  University of Texas Health Science Center at San Antonio, San Antonio, Texas
,
Steve N. Caritis
19  Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, Pennsylvania
,
; for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network› Author Affiliations
Further Information

Publication History

25 March 2014

25 March 2014

Publication Date:
17 June 2014 (online)

Abstract

Objective To test whether elevated umbilical cord serum inflammatory cytokine levels predicted subsequent cerebral palsy (CP) or neurodevelopmental delay (NDD).

Study Design Nested case-control analysis within a clinical trial of antenatal magnesium sulfate (MgSO4) before anticipated preterm birth (PTB) for prevention of CP, with evaluation of surviving children at the age of 2. NDD was defined as a Bayley psychomotor developmental index (PDI) and/or mental developmental index (MDI) < 70. Controls, defined as surviving children without CP and with Bayley PDI and MDI ≥ 85, were matched by race and gestational age. Cord serum was analyzed for interleukin-8 (IL-8) interleukin-1 beta (IL-1β), and tumor necrosis factor-α (TNF-α) levels. Elevated cytokine levels were defined as ≥ 75th percentile in placebo-exposed controls. Analyses compared case/control cytokine levels, adjusting for MgSO4 exposure, gestational age, race/ethnicity, and sociodemographic differences.

Results Logistic regression analysis with 339 cases and 276 controls showed that elevated IL-8 and IL-1β were more common in cord blood serum from infants with subsequent low MDI as compared with controls. After adjusting for additional confounders, the significant differences were no longer evident. Cytokine levels (IL-8, IL-1β, and TNF-α) were not elevated with CP or low PDI.

Conclusion Cord serum IL-8, IL-1β, and TNF-α levels in preterm infants are not associated with subsequent CP or NDD.

Notes

Comments and views of the authors do not necessarily represent views of the NICHD or NINDS. (ClinicalTrials.gov number, NCT00014989.) Presented in part at the 30th annual meeting of the Society for Maternal-Fetal Medicine, Chicago, IL, February 4, 2010.