Prevention of Birth InjuriesThe Fetal Inflammatory Response SyndromeGOTSCH, 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* ‡Author Information *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: firstname.lastname@example.org Clinical Obstetrics and Gynecology: September 2007 - Volume 50 - Issue 3 - p 652-683 doi: 10.1097/GRF.0b013e31811ebef6 Buy Metrics Abstract 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. © 2007 Lippincott Williams & Wilkins, Inc.