产前发热对新生儿宫内细菌感染及脐血miRNA-155、NF-κB信号通路指标的影响

Effect of prenatal fever on neonatal intrauterine bacterial infection and the indexes of miRNA-155 and NF-κB signal pathway in cord blood

目的探讨产前发热对新生儿宫内细菌感染及脐血miRNA-155、核因子-κB(NF-κB)信号通路指标的影响。方法选取2018年1至12月在宁波市妇女儿童医院分娩的、产前体温>37.5℃的单胎孕妇及其新生儿200例为产前发热组,同期无产前发热但其余条件相同的100例单胎孕妇及其新生儿为健康对照组。分别以产前1周体温38.5℃、持续时间24h为界,将200例有产前发热史的孕妇分为高热组92例、低热组108例和长时间组80例、短时间组120例。比较产前发热组与健康对照组孕妇绒毛膜炎、新生儿宫内细菌感染发生率及脐血炎症指标[miRNA-155、p65、p50、NF-κB复合物抑制因子α(IκBα)、IKB激酶β(IKKβ)、白细胞介素8(IL-8)基因表达量及IL-8、超敏C反应蛋白(hs-CRP)水平],同时分析产前发热程度、持续时间与上述指标的关系,以及发热程度与持续时间的关系。结果产前发热组孕妇绒毛膜炎、新生儿宫内细菌感染发生率,miRNA-155、p65、p50、IKKβ、IL-8基因表达量及IL-8、hs-CRP水平均明显高于健康对照组(均P<0.05),IKBα基因表达量低于健康对照组(P<0.05)。对产前发热程度及持续时间作亚组分析:高热组、长时间组孕妇绒毛膜炎、新生儿宫内细菌感染发生率,miRNA-155、p65、p50、IKKβ、IL-8基因表达量及IL-8、hs-CRP水平均明显高于低热组、短时间组(均P<0.05),IKBα基因表达量低于低热组、短时间组(均P<0.05)。产前发热长、短时间组孕妇发热程度比较,差异无统计学意义(P>0.05)。结论产前发热孕妇绒毛膜炎及新生儿宫内细菌感染发生率较高,脐血miRNA-155基因表达上调,NF-κB信号通路激活;产前1周体温>38.5℃或持续时间>24h者表现更明显。

Objective To explore the effect of prenatal fever on neonatal intrauterine bacterial infection and the indexes of microRNA-155 and NF-κB signal pathway in cord blood.Methods Two hundred singleton pregnant women giving birth in Ningbo women and children’s hospital from January to December 2018,who had prenatal fever(>37.5℃),were enrolled in the study(prenatal fever group),and 100 singleton pregnant women without prenatal fever served as control group.The prenatal fever group were further divided into high fever group(≥38.5℃,n=92),low fever group(<38.5℃,n=108),long-time fever group(≥24h,n=80)and short-time fever group(<24h,n=120).The incidence of choriovillitis,intrauterine bacterial infection and cord blood inflammation indexes including miRNA-155,p65,p50,NF-κB complex inhibitorα(IκBα),IKB kinaseβ(IKKβ),interleukin-8(IL-8)gene and the levels of IL-8 and hs-CRP were compared between the prenatal fever group and the control group.The relationship between the above indexes and the degree or duration of fever were also analyzed.Results The incidence of choriositis and intrauterine bacterial infection,miRNA-155,p65,P50,IKKβ,IL-8 gene expression,IL-8 and hs-CRP levels in the prenatal fever group were significantly higher than those in the control group(all P<0.05),and IκBαgene expression was significantly lower than that in the healthy control group(P<0.05).The incidence of choriovillitis,intrauterine bacterial infection,miRNA-155,p65,p50,IKKβ,IL-8 gene expression,IL-8,hs-CRP level in the high fever group and long-time fever group were significantly higher than those in the low fever group and short-time fever group(all P<0.05),and the expression of IκBαgene was ower than that in the low fever group and short-time fever group(all P<0.05).There was no significant difference in fever degree between long-and short-time fever groups(P>0.05).Conclusion The incidence of choriovillitis and neonatal intrauterine bacterial infection in prenatal fever group is higher.The expression of miRNA-155 gene in cord blood is up-regulated,and the NF-κB signal pathway is activated.It is more marked when the temperature≥38.5℃or the duration≥24 hours in the week before birth.