Secreted phospholipase A2 is increased in meconium-stained amniotic fluid of term gestations: potential implications for the genesis of meconium aspiration syndrome. (July 2014)

• Record Type: Journal Article
• Authors: Romero, Roberto; Yoon, Bo Hyun; Chaemsaithong, Piya; Cortez, Josef; Park, Chan-Wook; Gonzalez, Rogelio; Behnke, Ernesto; Hassan, Sonia S.; Gotsch, Francesca; Yeo, Lami; Chaiworapongsa, Tinnakorn
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 27:Number 10(2014:Oct.)
• Page Start: 975
• Page End: 983
• Publication Date: 2014-07
• Subjects: Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.3109/14767058.2013.847918
• Languages: English
• ISSNs: 1476-7058

Abstract

<abstract> <title>Abstract</title> <p> <italic>Background</italic>: Meconium-stained amniotic fluid (MSAF) represents the passage of fetal colonic content into the amniotic cavity. Meconium aspiration syndrome (MAS) is a complication that occurs in a subset of infants with MSAF. Secreted phospholipase A<sub>2</sub> (sPLA<sub>2</sub>) is detected in meconium and is implicated in the development of MAS. The purpose of this study was to determine if sPLA<sub>2</sub> concentrations are increased in the amniotic fluid of women in spontaneous labor at term with MSAF.</p> <p> <italic>Materials and methods</italic>: This was a cross-sectional study of patients in spontaneous term labor who underwent amniocentesis (<italic>n</italic> = 101). The patients were divided into two study groups: (1) MSAF (<italic>n</italic> = 61) and (2) clear fluid (<italic>n</italic> = 40). The presence of bacteria and endotoxin as well as interleukin-6 (IL-6) and sPLA<sub>2</sub> concentrations in the amniotic fluid were determined. Statistical analyses were performed to test for normality and bivariate analysis. The Spearman correlation coefficient was used to study the relationship between sPLA<sub>2</sub> and IL-6 concentrations in the amniotic fluid.</p> <p> <italic>Results</italic>: Patients with MSAF have a higher median sPLA<sub>2</sub> concentration (ng/mL) in amniotic fluid than those with clear fluid [1.7 (0.98–2.89) versus 0.3 (0–0.6), <italic>p</italic> < 0.001]. Among patients with MSAF, those with either microbial invasion of the amniotic cavity (MIAC, defined as presence of bacteria in the amniotic cavity), or bacterial endotoxin had a significantly higher median sPLA<sub>2</sub> concentration (ng/mL) in amniotic fluid than those without MIAC or endotoxin [2.4 (1.7–6.0) versus 1.7 (1.3–2.5), <italic>p</italic> < 0.05]. There was a positive correlation between sPLA<sub>2</sub> and IL-6 concentrations in the amniotic fluid (Spearman Rho = 0.3, <italic>p</italic> < 0.05).</p> <p> <italic>Conclusion</italic>: MSAF that contains bacteria or endotoxin has a higher concentration of sPLA<sub>2</sub>, and this may contribute to induce lung inflammation when meconium is aspirated before birth.</p> </abstract>