title: Value of umbilical artery and vein levels of interleukin-6 and soluble intracellular adhesion molecule-1 as predictors of neonatal hematologic indices and suspected early sepsis.
abstract: This study was designed to evaluate the relationship of suspected early neonatal sepsis to umbilical artery and vein levels of interleukin-6 (IL-6) and soluble intracellular adhesion molecule-1 (sICAM-1). Umbilical artery and vein samples from 17 preterm and 6 term pregnancies were assayed for IL-6 (pg/ml) and sICAM-1 (ng/ml). Neonates were categorized as having probable or suspected sepsis vs. no sepsis within 3 days of birth. Levels of IL-6 and sICAM-1 were evaluated based on sepsis status. Neonatal hematologic parameters were correlated with umbilical artery (ua) and vein (uv) levels of IL-6 and sICAM-1. Sensitivity, specificity, positive and negative predictive values for detecting neonates having probable or suspected early sepsis were calculated. There were significant differences of IL-6 levels between suspected sepsis and no infants in the umbilical artery (P < 0.002) and vein (P < 0.0001). The sensitivity, specificity, positive and negative predictive values for detection of suspected early neonatal sepsis using umbilical artery IL-6 levels > 7 pg/ml were 88.5%, 66.6%, 58.8%, 91%, and for umbilical vein levels > 7 pg/ml these values were 88.5%, 93.3%, 88.5%, and 93.3%. Umbilical artery and vein IL-6 levels correlated with both absolute band counts and immature/total neutrophil ratios. sICAM-1 levels were not affected by designated sepsis status. Umbilical cord blood IL-6 (but not sICAM-1) is potentially useful as a marker for suspected early neonatal sepsis.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School/St. Peter's Medical Center, New Brunswick 08903-0591, USA. smuliajc@umdnj.edu
authors.forename: J C
authors.initials: JC
authors.lastname: Smulian
authors.forename: V
authors.initials: V
authors.lastname: Bhandari
authors.forename: W A
authors.initials: WA
authors.lastname: Campbell
authors.forename: J F
authors.initials: JF
authors.lastname: Rodis
authors.forename: A M
authors.initials: AM
authors.lastname: Vintzileos
mesh_terms: D015415:Biomarkers / Q000097:blood*; D005260:Female; D006801:Humans; D007234:Infant, Premature; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D011247:Pregnancy; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood / Q000175:diagnosis*; D012995:Solubility; D014469:Umbilical Arteries / Q000378:metabolism*; D014471:Umbilical Veins / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D018799:Intercellular Adhesion Molecule-1