Premature Birth and the Fetal Inflammatory Response Syndrome

Abstract

This review focuses on the subset of infected premature infants who suffer from the fetal inflammatory response syndrome (FIRS), which is defined as an acute systemic inflammatory response to intra-amniotic fluid infection. The typical patient with FIRS is premature and has an elevated level of fetal plasma interleukin 6, neutrophilia, suspected or proven sepsis, and a characteristic pattern of organ injury (in the lung, gut, brain, and other organs). Because it provides a novel way to understand etiology and pathogenesis, the literature on FIRS is an important body of work on the mechanisms of prematurity in the setting of infection. In this review, special consideration is given to the diagnosis of FIRS in a hospital setting and to the relationship among FIRS, encephalopathy, and cerebral palsy.