FETAL UMBILICAL CORD BLOOD ERYTHROPOIETIN, INTERLEUKIN-6, PH, PO2, PCO2, AND BASE EXCESS LEVELS IN HISTOLOGIC AND/OR CLINICAL CHORIOAMNIONITIS: IS THE RESPONSE ONLY INFLAMMATORY?

Abstract

Objective: To determine the correlation of histological chorioamnionitis (CA) with and without clinical CA with umbilical cord blood gases, erythropoietin (EPO), and interleukin-6 (IL-6) levels. Methods: Umbilical artery blood gas analysis (pH, pO2, pC02, BE) and umbilical vein EPO and IL-6 levels were measured in 202 infants from normal, histological, and no clinical CA and histological plus clinical CA pregancies. Results: Umbilical artery blood gas analyses were not different between normal controls and histological and clinical CA groups. Blanc Stage 1 histological CA had no abnormal EPO or IL-6 umbilical blood results. EPO in umbilical venous blood was elevated only in those infants with both histological and clinical CA. Umbilical vein IL-6 levels were elevated in all advanced microscopic and clinical CA. High and low EPO groups also have corresponding high and low IL-6 levels suggesting a common stimulus for these substances. Conclusions: Blanc stage I histological CA is probably clinically insignificant. CA is infrequently associated with abnormal umbilical artery blood gas levels. Advanced histological and clinical CA can elevate both EPO and IL-6 in umbilical blood and these may be key elements of mechanisms that effect fetal brain function.