ABSTRACT
Extremely low gestational age newborns (ELGANs, <28 completed weeks of gestation) that exhibit fetal and neonatal systemic inflammatory responses are at increased risk for developmental adversity, especially if the inflammatory process is sustained. We evaluated pro-inflammatory cytokine patterns in whole blood of 1220 ELGANs on one or more of postnatal days 1, 7, 14, 21, and 28. Protein concentrations were divided into quartiles within gestational week categories. We calculated odds ratios (OR) with 99 % confidence intervals (CI) for having a concentration in the top quartile for each protein given that the infant had a protein concentration in the top quartile 1 week or more earlier compared to infants who did not. ELGANs who have elevated systemic levels of IL-6R, TNF- α, or RANTES on their first postnatal day are approximately twice as likely to have elevated levels of these cytokines at the end of each of the first postnatal month. In some, this twofold risk increase persisted for the entire first postnatal month. In extremely preterm newborns, inflammatory processes can be sustained over weeks.
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ACKNOWLEDGMENTS
This study was supported by The National Institute of Neurological Disorders and Stroke (NS040069; NS040069), the National Eye Institute (EY021820), and the National Institute of Child Health and Human Development (HD018655).
ELGAN Study participating institutions, site principal investigators, and colleagues: Baystate Medical Center, Springfield MA (Bhavesh Shah, Karen Christianson). Beth Israel Deaconess Medical Center, Boston MA (Camilia R. Martin). Brigham & Women’s Hospital, Boston MA (Linda J. Van Marter). Children’s Hospital, Boston MA (Kathleen Lee, Anne McGovern, Jill Gambardella, Susan Ursprung, Ruth Blomquist). Massachusetts General Hospital, Boston MA (Robert Insoft, Jennifer G. Wilson, Maureen Pimental). New England Medical Center, Boston MA (Cynthia Cole, John Fiascone, Janet Madden, Ellen Nylen, Anne Furey). U Mass Memorial Health Center, Worcester, MA (Francis Bednarek [deceased], Mary Naples, Beth Powers). Yale-New Haven Hospital, New Haven CT (Richard Ehrenkranz, Joanne Williams). Forsyth Hospital, Baptist Medical Center, Winston-Salem NC (T. Michael O’Shea, Debbie Gordon, Teresa Harold). University Health Systems of Eastern Carolina, Greenville NC (Stephen Engelke, Sherry Moseley). North Carolina Children’s Hospital, Chapel Hill NC (Carl Bose, Gennie Bose). DeVos Children’s Hospital, Grand Rapids MI (Mariel Portenga, Dinah Sutton). Sparrow Hospital, Lansing MI (Padmani Karna, Carolyn Solomon). University of Chicago Hospital, Chicago IL (Michael D. Schreiber, Grace Yoon). William Beaumont Hospital, Royal Oak MI (Daniel Batton, Beth Kring).
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Dammann, O., Allred, E.N., Fichorova, R.N. et al. Duration of Systemic Inflammation in the First Postnatal Month Among Infants Born Before the 28th Week of Gestation. Inflammation 39, 672–677 (2016). https://doi.org/10.1007/s10753-015-0293-z
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DOI: https://doi.org/10.1007/s10753-015-0293-z