Interleukin-6 in preterm premature rupture of membranes as an indicator of neonatal outcome.
BACKGROUND
The aim of this study was to investigate whether the levels of interleukin-6 (IL-6) can be used as markers of adverse outcome in preterm neonates born after preterm premature rupture of membranes (PPROM).


METHODS
This study involved 109 preterm neonates and their mothers. The PPROM group consisted of 58 neonates who were born after PPROM, and the control group consisted of 51 neonates. IL-6 levels were measured in umbilical cord blood, maternal blood sampled during delivery and in neonatal blood taken on the fourth day of life.


RESULTS
In the PPROM group, IL-6 concentrations in maternal blood, cord blood, and neonatal blood were significantly higher in neonates with sepsis, compared with those without sepsis (P < 0.001). Choosing 108.5 pg/ml as a cut-off concentration of IL-6 in umbilical cord blood for neonatal sepsis resulted in sensitivity 95%, specificity 100%, positive predictive value 100%, and negative predictive value 97.4%. Concerning IL-6 in maternal blood, a cut-off concentration of 81 pg/ml showed sensitivity 90%, specificity 97.4%, positive predictive value 94.7%, and negative predictive value 94.9%. Eighteen of 20 neonates with early sepsis and seven of nine neonates, who died in the PPROM group, were born of mothers with IL-6 levels above the cut-off concentration in their blood during delivery.


CONCLUSIONS
IL-6 in umbilical cord blood was the most significant variable for predicting early onset sepsis in preterm neonates. IL-6 in maternal blood was indicative of intrauterine environmental threats and might be used to identify pregnancies where intervention would be appropriate.
Hatzidaki
Eleftheria
E
Department of Neonatology, University of Crete, Greece. ekibolos@med.uoc.gr
Gourgiotis
Dimitris
D
Manoura
Antonia
A
Korakaki
Eftychia
E
Bossios
Apostolos
A
Galanakis
Emmanouel
E
Giannakopoulou
Christina
C
D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis*; D015850:Interleukin-6 / Q000097:blood*; D016014:Linear Models; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis*
D015415:Biomarkers; D015850:Interleukin-6