Document Detail


Intrapartum fever at term: serum and histologic markers of inflammation.
MedLine Citation:
PMID:  12548228     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
John C Smulian; Vineet Bhandari; Anthony M Vintzileos; Susan Shen-Schwarz; Carlene Quashie; Yu-Ling Lai-Lin; Cande V Ananth
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  188     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-01-27     Completed Date:  2003-02-20     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  269-74     Citation Subset:  AIM; IM    
Affiliation:
Division of Maternal-Fetal Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School/Saint Peter's University Hospital, New Brunswick, NJ, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Case-Control Studies
Chorioamnionitis / blood,  pathology
Continental Population Groups
Female
Fetal Blood / chemistry
Fetal Diseases
Fever*
Gestational Age
Humans
Inflammation / blood,  diagnosis*,  pathology
Interleukin-6 / blood
Labor, Obstetric*
Parity
Physical Examination
Placenta / pathology
Pregnancy
Prospective Studies
Regression Analysis
Risk Factors
Tachycardia
Umbilical Veins
Vagina
Chemical
Reg. No./Substance:
0/Interleukin-6

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