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Klin Padiatr 2013; 225(02): 70-74
DOI: 10.1055/s-0033-1334879
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Levels of Cytokines in Umbilical Cord Blood in Small for Gestational Age Preterm Infants

Zytokinkonzentrationen im Nabelschnurblut von hypotrophen Frühgeborenen
U. Lindner
1   Center of Pediatrics and Neonatology, University of the Saarland, ­Homburg, Germany
,
E. Tutdibi
1   Center of Pediatrics and Neonatology, University of the Saarland, ­Homburg, Germany
,
S. Binot
2   Neonatology, Grosshadern, Ludwig-Maximilian University, Munich, ­Germany
,
D. Monz
1   Center of Pediatrics and Neonatology, University of the Saarland, ­Homburg, Germany
,
A. Hilgendorff
2   Neonatology, Grosshadern, Ludwig-Maximilian University, Munich, ­Germany
,
L. Gortner
1   Center of Pediatrics and Neonatology, University of the Saarland, ­Homburg, Germany
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
22. März 2013 (online)

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Abstract

Introduction:

Being born small for gestational age (SGA) can be a reference to intrauterine growth retardation (IUGR) and is associated with increased neonatal morbidity and mortality. In pregnancies complicated by IUGR placental insufficiency is thought to be one of the leading underlying pathogenetic mechanisms. As cytokines appear to be implicated in implantation and ­placental development, imbalances in cytokine levels may contribute to pregnancy disorders i. e., IUGR.

Objective:

Cord blood cytokine profiles were analyzed in order to characterize differences in cytokine profiles between SGA and appropriate for gestational age (AGA) preterm infants.

Methods:

Cytokine concentrations were measured in venous cord blood of preterm infants delivered by caesarean section without previous labour activity and without signs of maternal or fetal infection.

Results:

93 preterm infants were enrolled, 29 SGA preterm infants (GA 31.0 (24.6–36.7) weeks; BW 1080 (315–2010) grams) and 63 AGA preterm infants (GA 33.3 (26.0–36.9) weeks; BW 1790 (760–3570) grams). In both groups multiple cytokines could be detected. Significant differences in cytokine levels between the groups were found for G-CSF, IL-12p40 and IL-8, while levels of IL-1a, IL-6, IL-10, IP-10, MCP-1, MCP-3, MIP-1a and TNF-a were not different.

Conclusions:

Alteration of cytokine levels in SGA preterm infants may be involved in the pathogenesis of reduced intrauterine growth as well as in the higher morbidity in these infants. Further studies are needed to get more comprehension of the complex function of cytokines in pregnancies complicated by IUGR.

Zusammenfassung

Einleitung:

Ein für das Gestationsalter zu nie­driges Geburtsgewicht (SGA) kann Hinweis auf eine intrauterine Wachstumsretardierung (IUGR) sein, welche einen Risikofaktor für eine erhöhte neonatale Morbidität und Mortalität darstellt. Pathogenetisch liegt einer IUGR häufig eine Plazentainsuffizienz zu Grunde. Da Zytokine im Rahmen der Implantation und Plazentaentwicklung eine wesentliche Funktion einzunehmen scheinen, wird ein Einfluss veränderter Zytokinspiegel auf einen pathologischen Schwangerschaftsverlauf z. B. bei IUGR diskutiert.

Zielsetzung:

Ziel der vorliegenden Arbeit war die Bestimmung von Zytokinprofilen im Nabelschnur­blut Frühgeborener, um mögliche Unterschiede zwischen SGA und eutrophen Frühgeborenen zu erfassen.

Methoden:

Die Bestimmung der Zytokinspiegel erfolgte aus venösem Nabelschnurblut, eingeschlossen wurden Frühgeborene geboren per Sectio ohne Wehentätigkeit und ohne kindliche oder mütterliche Infektionszeichen.

Ergebnisse:

93 Frühgeborene wurden in die Untersuchung eingeschlossen, 29 SGA Frühgeborene (GA 31,0 (24,6–36,7) SSW; GG 1080 (315–2010) g) und 63 eutrophe Frühgeborene (GA 33,3 (26,0–36,9) SSW; GG 1790 (760–3570) g). In beiden Gruppen konnten multiple Zytokine nachgewiesen werden. Signifikante Unterschiede zwischen den Gruppen wurden für G-CSF, IL-8 und IL-12p40 gefunden, während IL-1a, IL-6, IL-10, IP-10, MCP-1, MCP-3, MIP-1a und TNF-a keine signifikanten Unterschiede zeigten.

Schlussfolgerung:

Die beobachteten Verände­rungen einzelner Zytokinspiegel bei SGA Frühgeborenen könnten sowohl die Pathogenese des reduzierten Wachstums reflektieren als auch deren erhöhtes Morbiditätsrisiko bedingen. Weitere Studien sind notwendig, um die komplexen Funktionen von Zytokinen bei IUGR zu charakterisieren.

Key words

preterm neonates - cytokines - small for gestational age - intrauterine growth ­retardation

Schlüsselwörter

Frühgeborene - Zytokine - Hypotrophie - intrauterine ­Wachstumsretardierung
 

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