Components of the systemic fetal inflammatory response syndrome as predictors of impaired neurologic outcomes in children.
OBJECTIVE
The purpose of this study was to compare interleukin-6 and funisitis as predictors of impaired neurologic outcomes in children by performing a secondary analysis on data that were collected prospectively for another purpose.


METHODS
We examined umbilical cords for funisitis and obtained cord blood for interleukin-6 levels. A psychomotor developmental index score was determined for each child at age 18 months.


RESULTS
The prevalence (46%) of elevated interleukin-6 levels (> or = 10 pg/mL) among children with low psychomotor developmental index scores (<100) was not significantly different from that of children with normal scores (47%). Among children with funisitis (n = 21), the median psychomotor developmental index score was 94; for children without funisitis (n = 92), it was 99 (P <.02). When the data were regressed for confounding, funisitis remained significant (adjusted odds ratio, 1.3; 95% CI, 1.1-1.9). Furthermore, funisitis was a more specific predictor of low psychomotor developmental index scores (P <.001), although elevated interleukin-6 levels were more sensitive.


CONCLUSIONS
When used for the prediction of impaired neurologic outcomes in children, funisitis has better specificity and thus a better positive predictive value than does interleukin-6.
Mittendorf
Robert
R
Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, IL 60153, USA. rmitten@lumc.edu
Montag
Anthony G
AG
MacMillan
William
W
Janeczek
Susan
S
Pryde
Peter G
PG
Besinger
Richard E
RE
Gianopoulos
John G
JG
Roizen
Nancy
N
D000328:Adult; D002547:Cerebral Palsy / Q000151:congenital / Q000209:etiology*; D005260:Female; D005312:Fetal Blood; D005315:Fetal Diseases / Q000276:immunology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007249:Inflammation / Q000150:complications / Q000276:immunology*; D015850:Interleukin-6 / Q000097:blood / Q000276:immunology*; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014470:Umbilical Cord
D015850:Interleukin-6