The levels of the neutrophil elastase in the amniotic fluid of pregnant women whose infants develop bronchopulmonary dysplasia

Abstract

Objective: To clarify the association between amniotic neutrophil elastase levels and the development of bronchopulmonary dysplasia (BPD).

Methods: The database between July 2001 and December 2012 was reviewed for women with amniocentesis on admission for amniotic fluid neutrophil elastase levels and with singleton deliveries between 22 + 0 and 31 + 6 weeks of gestation. Following deliveries, placentas were examined for histologic chorioamnionitis. The peripheral blood of the neonates was analyzed for acute phase reactants.

Results: Among 294 infants, no, mild, moderate or severe BPD was observed in 126, 89, 40 and 39 infants, respectively. The medians of gestational age on admission, at premature rupture of membranes and at delivery were significantly smaller in BPD (+) when compared with BPD (−) (p < 0.001). The median level of amniotic neutrophil elastase on admission was significantly greater in BPD (+) than that in BPD (−). Histologic chorioamnionitis and funisitis were both detected more frequently in BPD (+) patients than in BPD (−) patients. In a logistic regression model, the only variable that affected an increased chance of BPD was the gestational age at delivery (odds ratio, 0.58; 95% confidence interval, 0.36–0.92; p = 0.021).

Conclusions: The level of amniotic neutrophil elastase cannot be a definitive risk factor for BPD.

• Amniotic fluid
• bronchopulmonary dysplasia
• chorioamnionitis
• funisitis
• neutrophil elastase

Acknowledgements

We thank the medical staff in the Department of Neonatology and Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya Daiichi Hospital for their support.

Declaration of interest

The authors report no declaration of interest.