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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / Dimitrou, G. / Grunebaum, G. E. / Hentschel, Roland / Kawabata, Ichiro / Keirse, M.J.M.C. / Kurjak M.D., Asim / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, MD, PhD, HonD, Istvan / Vetter, Klaus / Young, Bruce K. / Zimmermann, Roland / Köpcke, W.

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Maternal plasma retinol binding protein 4 in acute pyelonephritis during pregnancy

Edi Vaisbuch1, 2 / Roberto Romero1–3, , / Shali Mazaki-Tovi1, 2 / Juan Pedro Kusanovic1, 2 / Tinnakorn Chaiworapongsa1, 2 / Zhong Dong1 / Sun Kwon Kim1 / Giovanna Ogge1 / Maria Teresa Gervasi4 / Sonia S. Hassan1, 2

1Perinatology Research Branch, Intramural Division, NICHD/NIH/DHHS, Hutzel Women's Hospital, Bethesda, MD, and Detroit, MI, USA

2Department of Obstetrics and Gynecology, Wayne State University/Hutzel Women's Hospital, Detroit, MI, USA

3Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA

4Department of Obstetrics and Gynecology, Azienda Ospedaliera of Padova, Padova, Italy

Corresponding authors: Roberto Romero, MD and Edi Vaisbuch, MD Perinatology Research Branch, NICHD, NIH, DHHS Wayne State University/Hutzel Women's Hospital 3990 John R, Box 4 Detroit, MI 48201, USA Tel.: +1 (313) 993-2700 Fax: +1 (313) 993-2694 ;

Citation Information: Journal of Perinatal Medicine. Volume 38, Issue 4, Pages 359–366, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: 10.1515/jpm.2010.066, February 2010

Publication History

Published Online:


Objective: Adipokines have been implicated in metabolic regulation and the immune response thus providing a molecular mechanism for the interaction between these two systems. Retinol binding protein 4 (RBP4) is a novel adipokine that plays a role in the pathophysiology of obesity-induced insulin resistance, as well as in the modulation of inflammation. The aim of this study was to determine whether there are changes in maternal plasma concentrations of RBP4 in pregnant women with acute pyelonephritis.

Study design: This cross-sectional study included pregnant women in the following groups: 1) normal pregnancy (n=80); 2) pyelonephritis (n=39). Maternal plasma RBP4 concentrations were determined by enzyme-linked immunoassays. Non-parametric statistics were used for analyses.

Results: 1) The median maternal plasma RBP4 concentration was lower in patients with acute pyelonephritis than in those with a normal pregnancy (3709.6 ng/mL, interquartile range (IQR) 2917.7–5484.2 vs. 9167.6 ng/mL, IQR 7496.1– 10,384.1, P<0.001; 2) the median maternal plasma RBP4 concentration did not differ significantly between patients with acute pyelonephritis who had a positive blood culture and those with a negative culture (3285.3 ng/mL, IQR 2274.1–4741.1 vs. 3922.6 ng/mL, IQR 3126.8–5547.1, respectively, P=0.2); and 3) lower maternal plasma RBP4 concentrations were independently associated with pyelonephritis after adjustment for confounding factors.

Conclusions: In contrast to what has been reported in preeclampsia, acute pyelonephritis during pregnancy is associated with lower maternal plasma RBP4 concentrations than in normal pregnancy. This finding suggests that the acute maternal inflammatory process associated with pyelonephritis is fundamentally different from that of the chronic systemic inflammatory process suggested in preeclampsia, in which RBP4 concentrations were found to be elevated.

Keywords: Adipokines; bacterial infection; pregnancy; RBP4; sepsis; systemic inflammation; urinary tract infection, UTI

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