BackgroundTo characterize the influence of microbial invasion of the amniotic cavity (MIAC) and/or intra-amniotic inflammation (IAI) on the intensity of the fetal inflammatory response and the association between the presence of the fetal inflammatory response syndrome (FIRS) and short-term neonatal morbidity in the preterm prelabor rupture of membranes (PPROM) between the gestational ages of 34 and 37 weeks.MethodsOne hundred and fifty-nine women were included in the study. The umbilical cord blood interleukin (IL)-6 concentrations were determined using enzyme-linked immunosorbent assay kits. FIRS was defined based on the umbilical cord blood IL-6 concentration and the presence of funisitis and/or chorionic plate vasculitis.ResultsWomen with both MIAC and IAI had the highest median umbilical cord blood IL-6 concentrations and highest rates of FIRS. Women with FIRS had the higher rates of early-onset sepsis and intraventricular hemorrhage grades I and II when FIRS was characterized based on the umbilical cord blood IL-6 concentrations and the histopathological findings.ConclusionThe presence of both MIAC and IAI was associated with a higher fetal inflammatory response and a higher rate of FIRS. Different aspects of short-term neonatal morbidity were related to FIRS when defined by umbilical cord blood IL-6 concentrations and the histopathology of the placenta.

Department of Clinical Immunology and Allergy University Hospital in Hradec Kralove Charles University Faculty of Medicine Hradec Kralove Hradec Kralove Czech Republic

Department of Obstetrics and Gynecology Sahlgrenska Academy Gothenburg University Gothenburg Sweden

Department of Obstetrics and Gynecology University Hospital in Hradec Kralove Charles University Faculty of Medicine Hradec Kralove Hradec Kralove Czech Republic

Fingerland's Department of Pathology University Hospital in Hradec Kralove Charles University Faculty of Medicine Hradec Kralove Hradec Kralove Czech Republic

Institute of Clinical Biochemistry and Diagnostics University Hospital in Hradec Kralove Charles University Faculty of Medicine Hradec Kralove Hradec Kralove Czech Republic

Institute of Clinical Microbiology University Hospital in Hradec Kralove Charles University Faculty of Medicine Hradec Kralove Hradec Kralove Czech Republic

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