Document Detail


Fetal-placental inflammation, but not adrenal activation, is associated with extreme preterm delivery.
MedLine Citation:
PMID:  22264652     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Spontaneous labor at term involves the activation of placental corticotropin-releasing hormone and the fetal adrenal axis, but the basis for extreme preterm labor is unknown. Our objective was to determine whether placental corticotropin-releasing hormone is activated in extreme preterm labor.
STUDY DESIGN: One thousand five hundred six mothers delivering at less than 28 weeks' gestation were enrolled. Each mother/infant pair was assigned to the category that described the primary reason for hospitalization. Observers who had no knowledge of patient categorization assessed placenta microbiology, histology, and corticotropin-releasing hormone expression. These were correlated with the primary reason for hospitalization.
RESULTS: Among infants delivered at less than 28 weeks' gestation, spontaneous (vs induced) delivery was associated with less placental corticotropin-releasing hormone expression and more frequent signs of placental inflammation and infection.
CONCLUSION: Inflammation and infection, rather than premature activation of the fetal adrenal axis, should be the major focus of research to prevent extremely preterm human birth.
Authors:
Sunita Trivedi; Maria Joachim; Thomas McElrath; Harvey J Kliman; Elizabeth N Allred; Raina N Fichorova; Andrew Onderdonk; Fernanda Heitor; Leila Chaychi; Alan Leviton; Joseph A Majzoub;
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-12-16
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  206     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-03-02     Completed Date:  2012-04-24     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  236.e1-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012. Published by Mosby, Inc.
Affiliation:
Division of Endocrinology, Department of Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Glands / metabolism
Chorioamnionitis / microbiology*
Cohort Studies
Corticotropin-Releasing Hormone / analysis
Cytokines / blood
Female
Humans
Infant, Newborn
Male
Multicenter Studies as Topic
Placenta / chemistry,  cytology,  microbiology
Pregnancy
Pregnancy Complications, Infectious / microbiology*
Pregnancy Outcome
Premature Birth / microbiology*
Grant Support
ID/Acronym/Agency:
5U01NS040069-05/NS/NINDS NIH HHS; P30 HD018655/HD/NICHD NIH HHS; P30-HD-18655/HD/NICHD NIH HHS; U01 NS040069/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Cytokines; 9015-71-8/Corticotropin-Releasing Hormone
Comments/Corrections

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