Cord blood biomarkers of the fetal inflammatory response

Karen Mestan*, Yunxian Yu, Poul Thorsen, Kristin Skogstrand, Nana Matoba, Xin Liu, Rajesh Kumar, David M. Hougaard, Munish Gupta, Colleen Pearson, Katherin Ortiz, Howard Bauchner, Xiaobin Wang

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

50 Scopus citations


Objective. In current, neonatal practice, clinical signs of intrauterine infection (IUI) are often non-specific. From a large panel of immune biomarkers, we seek to identify cord blood markers that are most strongly associated with the fetal inflammatory response (FIR), a specific placental lesion associated with serious neonatal complications. Methods. We used multiplex immunoassay to measure 27 biomarkers, selected as part of an NIH-funded study of preterm birth, according to gestational age (GA) and extent of placental inflammation: involvement of chorion, amnion, decidua (maternal inflammatory response, MIR); extension to umbilical cord or chorionic plate (FIR). We used false-discovery rate (FDR < 5, P < 0.001) to account for multiple comparisons. Results. Among 506 births GA 2342 weeks, IL-1β increased with FIR among preterm subgroups P 0.0001 for <32 weeks; P 0.0009 for 3336 weeks. IL-6 and IL-8 increased with FIR among preterm and full-term infants P < 0.0001. P-trend for IL-6 and IL-8 with MIR versus FIR was <0.0001. Comparison with respect to clinical IUI yielded persistent elevation with FIR even when clinical signs were absent. The remaining 24 markers were not significantly associated. Conclusion. We conclude that among 27 cord blood biomarkers, IL-1β, IL-6 and IL-8 are selectively associated with FIR. These markers may be clinically useful indicators of extensive IUI associated with poor neonatal outcome.

Original languageEnglish (US)
Pages (from-to)379-387
Number of pages9
JournalJournal of Maternal-Fetal and Neonatal Medicine
Issue number5
StatePublished - Nov 24 2009


  • Chorioamnionitis
  • Cytokines
  • Intrauterine infection
  • Placenta

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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