Amniotic fluid tumor necrosis factor-alpha is a marker for the prediction of early-onset neonatal sepsis in preterm labor

被引:23
作者
Park, KH
Yoon, BH
Shim, SS
Jun, JK
Syn, HC
机构
[1] Seoul Natl Univ, Coll Med, Dept Obstet, Seoul, South Korea
[2] Seoul Natl Univ, Coll Med, Dept Gynecol, Seoul, South Korea
关键词
amniotic fluid; tumor necrosis factor-alpha; early-onset neonatal sepsis; preterm labor;
D O I
10.1159/000078492
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Background: Our purpose was to determine whether amniotic fluid concentrations of tumor necrosis factor-alpha are of value in the prediction of early-onset neonatal sepsis ( proven or suspected) in patients with preterm labor and intact membranes. Methods: The relationship between amniotic fluid tumor necrosis factor-alpha concentrations and early-onset neonatal sepsis was examined in 59 consecutive patients with preterm labor and intact membranes who delivered preterm neonates within 72 h after transabdominal amniocentesis. Early-onset neonatal sepsis was defined either as the presence of a positive blood culture or as suspected sepsis within 72 h of delivery. Tumor necrosis factor-alpha was determined by enzyme-linked immunosorbent assays. Results: Patients delivering neonates with early-onset neonatal sepsis had significantly higher median amniotic fluid TNF-alpha concentrations than patients delivering neonates without earlyonset neonatal sepsis ( p < 0.0005). An amniotic fluid tumor necrosis factor-alpha concentration >= 41 pg/ml had a sensitivity of 82% (23/29) and specificity of 79% (38/48) in the prediction of early-onset neonatal sepsis. Multiple logistic regression indicated that elevated amniotic fluid tumor necrosis factor-alpha (>= 41 pg/ml) was the only independent predictor of early-onset neonatal sepsis ( odds ratio 12.9, 95% confidence interval 1.3 - 125.3, p = 0.01) after correction for known confounding variables. Conclusions: ( 1) Amniotic fluid tumor necrosis factor-alpha is a marker for the prediction of early-onset neonatal sepsis in patients with preterm labor and intact membranes. ( 2) Amniotic fluid tumor necrosis factor-alpha is a better independent predictor of early-onset neonatal sepsis than placental histologic finding or amniotic fluid culture. Copyright (C) 2004 S. Karger AG, Basel.
引用
收藏
页码:84 / 90
页数:7
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