Umbilical cord interleukin-6 levels are elevated in term neonates with perinatal asphyxia.
BACKGROUND
A correlation between elevation of pro-inflammatory cytokines and white matter injury or abnormal neurologic outcome has been established in the preterm infant. In the full-term neonate, few studies exist linking elevation of cytokines with encephalopathy and poor neurodevelopmental outcome. Our aims were to investigate if serum interleukin-6 concentrations in delivering mothers and their offspring at birth are associated with perinatal asphyxia, and to examine the relation of interleukin-6 levels to the severity of hypoxic-ischemic encephalopathy and to the neurological outcome.


METHODS
Serum interleukin-6 levels were measured at birth, 24 and 48 h of life in 50 consecutive term uninfected newborns with perinatal asphyxia and 113 randomly selected healthy term newborns, and at delivery in their mothers.


RESULTS
The median cord interleukin-6 concentrations in the infants who developed hypoxic-ischemic encephalopathy was 376-fold as high as the values in the normal infants (P < 0.0001) and 5.5-fold as high as those in the infants with asphyxia who did not develop hypoxic-ischemic encephalopathy (P < 0.05). There was also a significant relationship between interleukin-6 and the degree of hypoxic-ischemic encephalopathy, and between interleukin-6 and neurodevelopmental outcome at 2 years of age. Regardless of outcome, in the asphyxiated infants the interleukin-6 values were significantly lower at both 24 and 48 h of life than at birth, with a significant decline from 24 to 48 h of life. Among mothers of the asphyxiated neonates, there were no significant differences in interleukin-6 concentrations between those delivering neonates with and without hypoxic-ischemic encephalopathy.


CONCLUSIONS
Measurement of IL-6 concentrations in the umbilical cord of neonates with perinatal asphyxia may be useful to identify early, and in a relatively simple way, those who are most likely to have subsequent brain injury and adverse outcome.
Chiesa
C
C
National Research Council, Rome, Italy. Claudio.Chiesa@Uniroma1.it
Pellegrini
G
G
Panero
A
A
De Luca
T
T
Assumma
M
M
Signore
F
F
Pacifico
L
L
D000328:Adult; D001238:Asphyxia Neonatorum / Q000097:blood* / Q000150:complications; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000209:etiology / Q000378:metabolism; D007231:Infant, Newborn; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D011446:Prospective Studies; D014470:Umbilical Cord / Q000378:metabolism*
D015850:Interleukin-6