calca-protein--human and Premature-Birth

Premature rupture of membranes is a common situation in obstetrics that links the amniotic cavity and the bacterial cervicovaginal flora. The main risk in case of preterm premature rupture of membranes is the occurrence of an amniochorial infection, which increases neonatal morbidity and mortality. One main purpose in cases of preterm premature rupture of membranes is to identify infection early to adapt the clinical care. Among the marker used in practice, CRP has a sensitivity between 56% and 86% and specificity between 55% and 82% for predicting clinical chorioamnionitis. These values are respectively 21% to 56% and 76% to 95% for the prediction of early neonatal infection. The white blood cell count, also used in routine, has a poor predictive value of clinical chorioamnionitis although a high specificity when the threshold is of 16 giga/l. Among the pro-inflammatory cytokines, interleukin-6 has been the most studied. Its predictive value for chorioamnionitis or neonatal infection is higher but its clinical usefulness is limited by the various threshold used in the studies and the lack of routine measure. Procalcitonin appears to have low predictive values for detecting amniochorial infection but has finally been little studied. Ways to improve prediction of infection in cases of premature rupture of membranes are either looking for new markers or the analysis of local markers (vaginal secretions and amniotic fluid).

Topics: Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Chorioamnionitis; Female; Fetal Membranes, Premature Rupture; Humans; Infant, Newborn; Interleukin-6; Leukocyte Count; Maternal-Fetal Exchange; Pregnancy; Pregnancy Complications, Infectious; Premature Birth; Protein Precursors; Sensitivity and Specificity; Vagina

Compared with full-term peers, premature infants are more likely to suffer from neonatal diseases and death. Variations in DNA methylation may affect these pathological processes. Calcitonin gene-related peptide (CGRP) plays a complex and diversified role in reproduction and chronic inflammation, and participates in the functional maintenance of vascular adaptation and trophoblast cells during pregnancy. Here, premature live births with single-chorionic triple embryos after single-embryo transfer were used as research objects, while full-term infants with double embryos and double-chorionic twins were used as controls. DNA was extracted from umbilical cord tissues for pyrosequencing to detect the methylation level of CpG island in CGRP promoter region. The average values of CGRP methylation in the umbilical cord tissues of very premature fetuses were higher than that of normal controls obtained from the databases. Immunofluorescence results showed that the expression of

Topics: Calcitonin Gene-Related Peptide; DNA Methylation; Embryo Transfer; Female; Humans; Infant, Extremely Premature; Infant, Newborn; Pregnancy; Pregnancy Outcome; Premature Birth

The arsenal of maternal and amniotic fluid (AF) immune response to local or systemic infection includes among others the acute-phase reactants IL-6, C-Reactive Protein (CRP) and Procalcitonin (PCT). If these molecules can be used as non-invasive biomarkers of intra-amniotic infection (IAI) in the subclinical phase of the disease remains incompletely known.. We used time-matched maternal serum, urine and AF from 100 pregnant women who had an amniocentesis to rule out IAI in the setting of preterm labor, PPROM or systemic inflammatory response (SIR: pyelonephritis, appendicitis, pneumonia) to infection. Cord blood was analyzed in a subgroup of cases. We used sensitive immunoassays to quantify the levels of inflammatory markers in the maternal blood, urine and AF compartment. Microbiological testing and placental pathology was used to establish infection and histological chorioamnionitis.. PCT was not a useful biomarker of IAI in any of the studied compartments. Maternal blood IL-6 and CRP levels were elevated in women with subclinical IAI. Compared to clinically manifest chorioamnionitis group, women with SIR have higher maternal blood IL-6 levels rendering some marginal diagnostic benefit for this condition. Urine was not a useful biological sample for assessment of IAI using either of these three inflammatory biomarkers.. In women with subclinical IAI, the large overlapping confidence intervals and different cut-offs for the maternal blood levels of IL-6, CRP and PCT likely make interpretation of their absolute values difficult for clinical decision-making.

Topics: Adult; Amniocentesis; Amniotic Fluid; Asymptomatic Infections; Biomarkers; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Chorioamnionitis; Female; Fetal Blood; Fetal Membranes, Premature Rupture; Humans; Infant, Newborn; Interleukin-6; Obstetric Labor, Premature; Placenta; Pregnancy; Pregnancy Complications, Infectious; Premature Birth; Protein Precursors; Systemic Inflammatory Response Syndrome

There is still no study evaluating the influence of gestational age (GA) per se on C reactive protein (CRP) and procalcitonin (PCT) reference intervals. We therefore investigated how length of gestation, age (hours), and prenatal and perinatal variables might influence the levels of CRP and PCT. We also determined 95% age-specific reference intervals for CRP and PCT in healthy preterm and term babies during the early neonatal period.. One blood sample (one observation per neonate) was taken for CRP and PCT from each newborn between birth and the first 4 (for term), or 5 days (for preterm newborns) of life by using a high-sensitive CRP and PCT assays.. Independently of gender and sampling time, GA had a significantly positive effect on CRP, and a significantly negative effect on PCT. Compared with healthy term babies, healthy preterm babies had a lower and shorter CRP response, and, conversely, an earlier, higher, and longer PCT response. CRP reference intervals were affected by a number of pro-inflammatory risk factors.. Age- and GA-specific reference ranges for both CRP and PCT should be taken into account to optimize their use in the diagnosis of early-onset neonatal sepsis.

Topics: Adult; Blood Chemical Analysis; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Female; Humans; Infant, Newborn; Male; Pregnancy; Premature Birth; Protein Precursors; Reference Standards; Term Birth; Time Factors

To compare procalcitonin (PCT) concentrations between maternal blood and levels in umbilical cord or venous blood of neonates who were born with or without infection.. Forty-six women with singleton pregnancies, complicated by premature rupture of membranes, preterm delivery and/or chorioamnionitis, were enrolled in this study. The study group comprised 15 patients and their infected newborns. The control group consisted of 31 women and their healthy newborns. We compared PCT concentrations between maternal, umbilical cord and neonatal serum, in both study and control groups. Additionally, PCT levels were compared between the corresponding compartments.. PCT concentrations in the umbilical cord and venous blood in infected newborns, but not in non-infected neonates, were significantly higher than maternal serum PCT levels. PCT concentrations of mothers who delivered infected newborns were comparable to those in the controls. However, PCT concentrations in the umbilical cord and in the venous blood of the infected newborns were higher than in healthy newborns.. Measurement of maternal PCT concentration during labor does not contribute to early prediction of infection in the neonate. However, umbilical cord PCT concentrations, as well as its neonatal venous levels on the second day of life, seem to be related to intrauterine infection, and may be a useful tool in the diagnosis of early neonatal infection.

Topics: Bacterial Infections; Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Chorioamnionitis; Female; Fetal Blood; Fetal Membranes, Premature Rupture; Humans; Infant, Newborn; Pregnancy; Pregnancy Complications; Premature Birth; Protein Precursors