Prematurity, infection, mortality, morbidity and interleukins: the reason or the result of preterm labor?

AIM: Primarly, the aim of this paper was to compare the effects of IL-1, IL-6, IL-8, and TNF-α in cord blood, and secondarily, to evaluate the effect of placental histology on early morbidity between appropriate for gestational age (AGA) preterm infants with preterm premature rupture of membranes (PPROM) and chorioamnionitis and without the history of PPROM and chorioamnionitis. METHODS: Forty preterm infants with PPROM and chrioamnionitis and 40 AGA preterm infants without PPROM (as a control group) have been included in the study. Umblical cord blood samples were taken and the plasma was separated right after the birth to study proinflammatory cytokines. RESULTS: Our histopathologic results showed that chorioamnionitis was present in preterm labor with or without PPROM, in 25% and 22.5%, respectively (P>0.05). No significant difference was observed in the rates of histologic chorioamnionitis (P>0.05), and in levels of IL-1, IL-6 and TNF-α (P>0.05). IL-8 levels in cord blood of PPROM (+) were found to be higher (P<0.05) but the sensitivity and specificity rates were low (60% and 65%). No statistical significance was observed in the morbidity and mortality rates between the AGA preterm infants with and without PPROM. CONCLUSION: We can concluded that, infections play an important role in the nature of preterm labor and that histologic chorioamnionitis may be found without the laboratory findings or the history of PPROM or clinical chorioamnionitis.