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The Fetal Inflammatory Response Syndrome

GOTSCH, FRANCESCA MD*; ROMERO, ROBERTO MD* †; KUSANOVIC, JUAN PEDRO MD*; MAZAKI-TOVI, SHALI MD* ‡; PINELES, BETH L. BS*; EREZ, OFFER MD*; ESPINOZA, JIMMY MD* ‡; HASSAN, SONIA S. MD* ‡

Clinical Obstetrics and Gynecology: September 2007 - Volume 50 - Issue 3 - p 652-683
doi: 10.1097/GRF.0b013e31811ebef6
Prevention of Birth Injuries

The fetal inflammatory response syndrome (FIRS) is a condition characterized by systemic inflammation and an elevation of fetal plasma interleukin-6. This syndrome has been observed in fetuses with preterm labor with intact membranes, preterm prelabor rupture of the membranes, and also fetal viral infections such as cytomegalovirus. FIRS is a risk factor for short-term perinatal morbidity and mortality after adjustment for gestational age at delivery and also for the development of long-term sequelae such as bronchopulmonary dysplasia and brain injury. Multiorgan involvement in FIRS has been demonstrated in the hematopoietic system, thymus, adrenal glands, skin, kidneys, heart, lung, and brain. This article reviews the fetal systemic inflammatory response as a mechanism of disease. Potential interventions to control an exaggerated inflammatory response in utero are also described.

*Perinatology Research Branch, Intramural Division, NICHD/NIH/DHHS, Hutzel Women's Hospital, Bethesda, Maryland, and Detroit, Michigan

Center for Molecular Medicine and Genetics, Wayne State University

Department of Obstetrics and Gynecology, Wayne State University/Hutzel Women's Hospital, Detroit, Michigan

Supported by the Intramural Program of the National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services. This work is not subject to copyright.

Correspondence: Dr Roberto Romero, MD, Perinatology Research Branch, Intramural Division, NICHD/NIH/DHHS, Hutzel Women's Hospital-Box No. 4, 3990 John R, Detroit, MI 48201. E-mail: nichdprbchiefstaff@mail.nih.gov

© 2007 Lippincott Williams & Wilkins, Inc.