Soluble intercellular adhesion molecule 1 in umbilical cord serum: potential for the diagnosis of neonatal infections.
OBJECTIVE
To evaluate the diagnostic relevance to neonatal infections of the soluble intercellular adhesion molecule 1 (sICAM-1) cord serum level.


METHODS
The case-control study included 66 term newborn infants with and without risk factors for neonatal infections. Cord blood serum determinations of white blood cell count, C-reactive protein, fibrinogen, and sICAM-1 were systematically performed associated with bacterial cultures from placenta, ears, and gastric fluids.


RESULTS
6 of 33 infants (18.2%) with risk factors were infected, and 13 (39.4%) were colonized. Two infants included in the group without infection risk factors (n = 33) were colonized. No difference in sICAM-1 cord serum levels was found according to the presence of premature rupture of membrane, fetal tachycardia >160 bpm, meconial amniotic fluid, and duration of labour >10 h. No difference in sICAM-1 was noted between infected and non-infected infants. The cord serum levels of sICAM-1 were significantly higher in infants after forceps extraction (p = 0.01). A correlation was observed between sICAM-1 and C-reactive protein cord serum levels (p = 0.004, r = 0.371) and between sICAM-1 level and neutrophil count (p = 0.01, r = 0.489).


CONCLUSIONS
Our results suggest that cord serum sICAM-1 determinations have no diagnostic relevance to neonatal infection. The increase of sICAM-1 cord serum levels in infants after forceps extraction suggests its potential to evaluate cerebral trauma or hypoxia.
Daraï
Emile
E
Service de Gynécologie-Obstétrique, Hôpital Bichat-Claude-Bernard, Paris, France.
Poncelet
Christophe
C
Soriano
David
D
Lejeune
Veronique
V
Bringuier
Annie-France
AF
Madelenat
Patrick
P
Feldmann
Gerard
G
Scoazec
Jean-Yves
JY
D001419:Bacteria / Q000302:isolation & purification; D001424:Bacterial Infections / Q000175:diagnosis*; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D036861:Delivery, Obstetric / Q000379:methods; D004423:Ear / Q000382:microbiology; D005312:Fetal Blood / Q000737:chemistry*; D005340:Fibrinogen / Q000032:analysis; D005750:Gastric Juice / Q000382:microbiology; D006801:Humans; D007231:Infant, Newborn; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D007958:Leukocyte Count; D009772:Obstetrical Forceps; D010920:Placenta / Q000382:microbiology; D011446:Prospective Studies; D012307:Risk Factors
D018799:Intercellular Adhesion Molecule-1; D005340:Fibrinogen; D002097:C-Reactive Protein