Umbilical cord blood interleukin-6 levels and neonatal morbidity

doi:10.1016/S0029-7844(97)00421-3

Obstetrics & Gynecology

Volume 90, Issue 5, November 1997, Pages 815-818

https://doi.org/10.1016/S0029-7844(97)00421-3 Get rights and content

Objective

To study umbilical cord interleukin-6 levels and the occurrence of neonatal sepsis, congenital pneumonia, necrotizing enterocolitis, and grade II–IV intraventricular hemorrhage.

Methods

Umbilical cord blood was collected from 133 preterm newborns. The study population was divided according to the presence or absence of neonatal complications. Interleukin-6 levels and clinical characteristics were compared by univariate and multivariate analyses.

Results

Sixteen neonates had adverse outcomes, and 117 were unaffected. The median interleukin-6 level was significantly higher in affected than in unaffected infants (145 pg/mL versus 0 pg/mL, P = .002). Elevated interleukin-6 levels were associated independently with neonatal morbidity in multiple logistic regression modeling that included gestational age, birth weight, and antenatal steroid exposure.

Conclusion

Umbilical cord blood interleukin-6 levels are elevated in neonates who subsequently develop sepsis, congenital pneumonia, necrotizing enterocolitis, or grade II–IV intraventricular hemorrhage.

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Authors should be aware of the STARD criteria before starting a study in this field. Previous studies have suggested that interpretation of the IL-6 response in early life may be affected and confounded by concurrent factors associated with stress, systemic injury and infection [74,79,93]. Absent from most publications on IL-6 accuracy studies for the diagnosis of EONS, however, are data on how the interpretation of the IL-6 response in the infected and uninfected neonates might have been hampered by the severity of the underlying illnesses (and their extent of inflammatory reaction).
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There was a trend toward the attenuation of inflammatory response and higher levels of neurotrophic cytokines in infants born to mothers with placental inflammation and exposure to ANS compared to infants born to mothers with placental inflammation and no ANS but these differences were not statistically significant. Several investigators have demonstrated that intrauterine infection in the preterm human fetus leads to increased levels of pro-inflammatory cytokines [8,10,11]. However, the effect of intrauterine infection/inflammation on levels of anti-inflammatory cytokines has not been studied so far.
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Exposure to ANS had no significant effect on the cord blood concentrations of cytokines measured in this study. All three pro-inflammatory cytokine levels and levels of IL-10 were significantly increased and cord blood levels of TGF-β and NT-3 were significantly decreased in infants with placental inflammation.
Although exposure to ANS did not have any significant effect on cord blood levels of cytokines, there was a trend toward the attenuation of inflammatory response and higher levels of neurotrophic cytokines in infants born to mothers with placental inflammation and exposure to ANS compared to infants born to mothers with placental inflammation and no ANS exposure.
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Umbilical cord blood interleukin-6 levels and neonatal morbidity

Objective

Methods

Results

Conclusion

Am J Obstet Gynecol

Am J Obstet Gynecol

Am J Obstet Gynecol

Clin Perinatol

Am J Obstet Gynecol