M.N. Liu1#, Y.K. Zhao#2, W.B. Chen2, D.P. Wang3, R.J. Dong4, Q.Y. Xu5, Y.Z. Jin6, Y. Li7, S.Q. Lu7, Z.A. Jin7 and J.Y. Wang8

Author information

1Affiliated Hospital of Yanbian University, Changchun City, Jilin, China;
2Neonatology Department, Rizhao people’s Hospital of Shandong Province, Donggang District, Rizhao City, Shandong Province, China;
3Gynecology Department, Dunhua Hospital of traditional Chinese Medicine, Dunhua, Jilin, China;
4Department of Gynecology and Obstetrics, Affiliated Hospital of Jilin Medical University, Jilin, China;
5Department of Obstetrics, Jilin Guojian Obstetrics and Gynecology Hospital, Lvyuan District, Changchun, Jilin, China;
6Department of Obstetrics and Gynecology, Affiliated Hospital of Yanbian University, Yanji City, Yanbian City, Jilin Province, China;
7Department of Pediatrics, Affiliated Hospital of Yanbian University, Yanji, Jilin, China; 8Dalian Women and Children’s Medical Center (Group), Dalian, Liaoning, China

#These authors contributed equally to this work

Abstract

Background: There is an increase in the number of premature births due to the premature rupture of the fetal membrane (PROM). Premature infants are more susceptible to infection, but early signs of infection can be difficult to detect in neonates. Soluble trigger receptor -1 (sTREM-1) was expressed by myeloid cell, mid-regional pro-adrenomedullin (MR-proADM), and IL-6 may be useful markers for detecting early neonatal infection.
Methods: A retrospective analysis was conducted in 689 premature infants with and without PROM to determine the risk factors for infection in PROM. The correlations between neonatal infection after PROM and sTREM-1, MR-proADM, and IL-6 levels of the umbilical cord blood were assessed in a cohort of 50 singleton infants.
Results: Premature infants with PROM were divided into infected (n=151) and non-infected (n=234) groups and compared to 304 premature infants without PROM. No correlation was observed between PROM and ethnicity, gestational age, gender, or twin gestation. A significant correlation was observed between infection and PROM. In the PROM infants, there was a noteworthy correlation between gestational age and infection. Umbilical cord blood levels of sTREM-1, MR-proADM, and IL-6 were remarkably higher in the infected group than in the uninfected group.
Conclusion: Infection during pregnancy is the main risk factor for PROM. In PROM neonates, gestational age could be a major risk factor for infection. Umbilical cord blood sTREM-1 and MR-proADM levels, and to a lesser degree IL-6 levels, may be useful to predict early PROM and neonatal infection.

Keywords:

neonatal infection, MR-proADM, PROM, sTREM-1

Publication type

Journal Article

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