OBJECTIVE: There is no evidence for the participation of the @entity1 fetus in the mechanisms responsible for the onset of @entity3152 . We propose that @entity3152 in the setting of infection results from the actions of proinflammatory cytokines secreted as part of the fetal and/or maternal host response to microbial invasion. The objective of this study was to determine whether a systemic fetal inflammatory response, defined as an elevation of fetal plasma @entity650 concentrations, has a temporal relationship with the commencement of labor. STUDY DESIGN: After informed consent was obtained, amniocentesis and cordocentesis were performed in 41 @entity1 with preterm premature @entity397 who were not in labor on admission. Amniotic fluid was cultured for both aerobic and anaerobic bacteria, as well as for @entity9463 . Fetal plasma @entity650 was assayed by a sensitive and specific immunoassay. Statistical analyses included contingency tables and survival analysis with time-dependent Cox regression hazard modeling. RESULTS: Microbial invasion of the @entity2907 was present in 58.5% (24/41) of @entity1 . Fetuses with fetal plasma @entity650 concentrations > 11 pg/mL had a higher rate of spontaneous @entity3152 within 48 and 72 hours of the procedure than those with fetal plasma @entity650 levels < or = 11 pg/mL (88% vs 29% and 88% vs 35%, respectively; P < .05 for all comparisons). Moreover, @entity1 with initiation of labor and delivery within 48 hours of the procedure had a higher proportion of fetuses with plasma @entity650 values > 11 pg/mL than @entity1 delivered > 48 hours (58% [7/12] vs 8% [1/13], respectively; P < .05). Survival analysis indicated that fetuses with elevated fetal plasma @entity650 levels had a shorter cordocentesis-to-delivery interval than those without elevated fetal plasma @entity650 concentrations (median 0.8 days [range 0.1 to 5] vs median 6 days [range 0.2 to 33.6], respectively; P < .05). Time-dependent Cox regression hazard modeling indicated that fetal plasma @entity650 level was the only covariate significantly associated with the duration of pregnancy after we adjusted for gestational age, amniotic fluid @entity650 level, and the microbiologic state of the @entity2907 (P < .01). CONCLUSION: A systemic fetal proinflammatory cytokine response is followed by the onset of spontaneous @entity3152 in @entity1 with preterm premature @entity397 .

A fetal systemic inflammatory response is followed by the spontaneous onset of XXXX .

@entity1 :: ('9606', 'Species') :: ['human', 'patients'] @entity650 :: ('3569', 'Gene') :: ['interleukin-6'] @entity9463 :: ('MESH:D009175', 'Disease') :: ['mycoplasmas'] @entity2907 :: ('MESH:D000652', 'Disease') :: ['amniotic cavity'] @entity3152 :: ('MESH:D007752', 'Disease') :: ['preterm delivery', 'preterm labor', 'preterm parturition'] @entity397 :: ('MESH:D012421', 'Disease') :: ['rupture of membranes']
@entity3152 :: (MESH:D007752,Disease) :: ['preterm parturition']
