The importance of intra-amniotic inflammation in the subsequent development of atypical chronic lung disease

J Matern Fetal Neonatal Med. 2009 Oct;22(10):917-23. doi: 10.1080/14767050902994705.


Objective: To examine whether the intra-amniotic inflammation is a risk factor for the development of atypical chronic lung disease (CLD).

Study design: A retrospective cohort study was undertaken in 72 patients who delivered preterm neonates (gestational age: 24-32 weeks) within 5 days of amniocentesis and whose neonates subsequently developed CLD. Atypical CLD was defined as CLD without respiratory distress syndrome (RDS). Intra-amniotic inflammation was defined as an elevated amniotic fluid (AF) concentration of matrix metalloproteinase-8 (MMP-8) (>23 ng/ml).

Results: (1) Atypical CLD was identified in 54.2% (39/72) of cases with CLD; (2) there were no significant differences in the median gestational age at birth and the rate of antenatal corticosteroid use between infants with atypical CLD and CLD with RDS; (3) preterm newborns with atypical CLD had a significantly higher median AF MMP-8 concentration (median 373.1 ng/ml vs. 8.6 ng/ml, p = 0.003) and median AF white blood cell count (median 450.0/mm(3)vs. 5.5/mm(3), p = 0.009), and a higher rate of intra-amniotic inflammation (74.4%vs. 45.5%, p = 0.012) than those with CLD with RDS.

Conclusion: Intra-amniotic inflammation confers a greater risk for atypical CLD than for typical CLD with initial RDS. This novel observation strengthens the importance of prenatal inflammation as a mechanism of lung injury.

Publication types

  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chorioamnionitis* / epidemiology
  • Chronic Disease
  • Cohort Studies
  • Female
  • Fetal Membranes, Premature Rupture / epidemiology
  • Humans
  • Infant, Newborn
  • Infant, Premature, Diseases / epidemiology
  • Infant, Premature, Diseases / etiology
  • Inflammation / complications
  • Inflammation / epidemiology
  • Lung Diseases / congenital*
  • Lung Diseases / epidemiology
  • Lung Diseases / etiology*
  • Pregnancy
  • Pregnancy Complications, Infectious* / epidemiology
  • Premature Birth / epidemiology
  • Premature Birth / etiology
  • Retrospective Studies
  • Young Adult