OBJECTIVE: This study was undertaken to determine whether intrapartum fevers at term are associated with markers of acute inflammation in maternal, fetal, and placental compartments. STUDY DESIGN: Term cases with intrapartum fever (temperature >/=100.4 degrees F) were recruited with gestational age-matched controls. Maternal serum and umbilical vein blood were collected and assayed for interleukin-6 (IL-6) levels. Placentas were examined for histologic chorioamnionitis. Demographic and clinical data were collected and compared between cases and controls. RESULTS: Forty-seven case-control pairs were analyzed. Maternal IL-6 levels were higher in cases than in controls (median of 145 pg/mL vs 42 pg/mL, P <.0001). Umbilical vein IL-6 levels also were higher in cases than controls (median 9 pg/mL vs 3.5 pg/mL, P =.01), but more than half of levels in cases were below 11 pg/mL. Only 31.1% of febrile cases had moderate or severe histologic chorioamnionitis. Multivariable logistic regression identified maternal serum IL-6 levels, nulliparity, and number of vaginal examinations as the major predictors of intrapartum fever at term. CONCLUSION: The maternal inflammatory response as measured by maternal serum IL-6 levels is a strong marker for term intrapartum fever. The much weaker association of fetal and placental inflammatory responses suggest a smaller than expected contribution of intra-amniotic inflammation to term intrapartum fevers.
OBJECTIVE: This study was undertaken to determine whether intrapartum fevers at term are associated with markers of acute inflammation in maternal, fetal, and placental compartments. STUDY DESIGN: Term cases with intrapartum fever (temperature >/=100.4 degrees F) were recruited with gestational age-matched controls. Maternal serum and umbilical vein blood were collected and assayed for interleukin-6 (IL-6) levels. Placentas were examined for histologic chorioamnionitis. Demographic and clinical data were collected and compared between cases and controls. RESULTS: Forty-seven case-control pairs were analyzed. Maternal IL-6 levels were higher in cases than in controls (median of 145 pg/mL vs 42 pg/mL, P <.0001). Umbilical vein IL-6 levels also were higher in cases than controls (median 9 pg/mL vs 3.5 pg/mL, P =.01), but more than half of levels in cases were below 11 pg/mL. Only 31.1% of febrile cases had moderate or severe histologic chorioamnionitis. Multivariable logistic regression identified maternal serum IL-6 levels, nulliparity, and number of vaginal examinations as the major predictors of intrapartum fever at term. CONCLUSION: The maternal inflammatory response as measured by maternal serum IL-6 levels is a strong marker for term intrapartum fever. The much weaker association of fetal and placental inflammatory responses suggest a smaller than expected contribution of intra-amniotic inflammation to term intrapartum fevers.
Authors: Roberto Romero; Piya Chaemsaithong; Nikolina Docheva; Steven J Korzeniewski; Adi L Tarca; Gaurav Bhatti; Zhonghui Xu; Juan P Kusanovic; Zhong Dong; Noppadol Chaiyasit; Ahmed I Ahmed; Bo Hyun Yoon; Sonia S Hassan; Tinnakorn Chaiworapongsa; Lami Yeo Journal: J Perinat Med Date: 2016-01 Impact factor: 1.901
Authors: Imran N Mir; Naseem Uddin; Jie Liao; Larry S Brown; Rachel Leon; Lina F Chalak; Rashmin C Savani; Charles R Rosenfeld Journal: Pediatr Res Date: 2022-06-11 Impact factor: 3.756
Authors: Roberto Romero; Piya Chaemsaithong; Nikolina Docheva; Steven J Korzeniewski; Adi L Tarca; Gaurav Bhatti; Zhonghui Xu; Juan P Kusanovic; Noppadol Chaiyasit; Zhong Dong; Bo Hyun Yoon; Sonia S Hassan; Tinnakorn Chaiworapongsa; Lami Yeo; Yeon Mee Kim Journal: J Perinat Med Date: 2016-01 Impact factor: 1.901
Authors: M Prabhu; K Cagino; K C Matthews; R L Friedlander; S M Glynn; J M Kubiak; Y J Yang; Z Zhao; R N Baergen; J I DiPace; A S Razavi; D W Skupski; J R Snyder; H K Singh; R B Kalish; C M Oxford; L E Riley Journal: BJOG Date: 2020-08-13 Impact factor: 7.331