THE AIM of the study was an evaluation of the relationship between histological chorioamnionitis and cord blood soluble intercellular adhesion molecule-1 (sICAM-1) and CRP levels.
Material and methods: in the group of 152 neonates observed for early onset infection (clinical and laboratory signs) the relationship between histological chorioamnionitis and cord blood sICAM-1 (ELISA) and CRP (turbidimetric method) levels was assessed. All these newborns were born in the years 2002-2004 to mothers with risk factors of perinatal infection.
Results: histological chorioamnionitis (ChA) was found in 50 cases, while early onset infection signs occurred in 112 neonates. The percentage of ill and healthy newborns in group with ChA and without ChA was similar. There were significantly higher sICAM-1 (p<0.001) levels in neonates from pregnancy complicated with ChA than without ChA (179 +/- 68.7 v. 147 +/- 30.8 ng/ml). There was not such difference in the CRP levels. There was also a significant positive correlation between cord blood sICAM-1 and ChA in the whole analyzed group of patients (r=0.26; p<0.001) and in the group of ill neonates (r=0.37; p<0.0001). There was a significant difference (p<0.001) in sICAM-1 levels between ill and healthy neonates from the group with ChA (191,8 +/- 73.9 v. 143,4 +/- 31.9 ng/ml) but not without ChA. No difference was found in sICAM-1 levels between groups of healthy neonates born after pregnancy complicated and not complicated with ChA.
Conclusions: coexistence of ChA and early onset infection in neonates enhanced the cord blood sICAM-1 levels. Healthy newborns born from pregnancy complicated by ChA do not react by increasing cord blood sICAM-1 levels. It is not possible to exclude early onset infection in neonates on the basis of normal cord blood sICAM-1 levels, because ill newborns born after pregnancy not complicated with ChA also do not react with increasing sICAM-1 production at birth.