[Cord blood levels of interleukin 6 in preterm infants as an early marker of neonatal morbidity].
BACKGROUND
The prematurity rate in our country is 8-9 %. Despite the decrease in neonatal mortality during the last decade, there is still a high incidence of neonatal morbidity and its subsequent sequelae. It is well known that the fetal inflammatory response plays an important role in the presence of neonatal morbidity. The aim of this study is to determine if interleukin 6 (IL-6) measurements in cord blood are a useful parameter to recognize those preterms with higher probability of suffering neonatal morbidity.


METHODS
Descriptive and prospective study in newborns with gestational ages (GA) < or = 34 weeks. We determined IL-6 levels in cord blood; white cell count and C reactive protein (CRP) levels at 0, 12, 24 and 72 hours of life, and blood culture at admission. Clinical data was also collected, including perinatology factors, symptomatology on admission and subsequent evolution until discharge or death.


RESULTS
We included 99 newborns with a GA between 23 and 34 weeks and birth weights between 480 and 2,855 g. Levels of IL-6 > 10 pg/ml show a significant correlation between maternal fever and/or chorioamnionitis (P = 0.005), a weak but significant correlation (P = 0.05, r = 0.3) between increased levels of CRP at 24 hours of life and Critical Risk Index for Babies (CRIB) score > or = 4 (P < 0.003, r = 0.2) and a significant correlation (P = 0.04) with the presence of periventricular leukomalacia (PVL) and with length of hospital stay (P = 0.0015). Patients with a lower GA show a trend to have higher levels of IL-6.


CONCLUSIONS
IL-6 could be a useful and early marker of neonatal morbidity. Its rapid ability to predict neonatal morbidity gives it an advantage over other classical blood markers.
Martínez Nadal
S
S
Servicios de Neonatología y Pediatría, Hospital de Barcelona, SCIAS, Barcelona, Spain. neonatos@sciashdb.com
Elizari Saco
M J
MJ
Fernández Delclos
D
D
Demestre Guasch
X
X
Sala Castellví
P
P
Vila Ceren
C
C
Raspall Torrent
F
F
D015415:Biomarkers; D005312:Fetal Blood / Q000378:metabolism*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000097:blood* / Q000276:immunology*; D007234:Infant, Premature; D015850:Interleukin-6 / Q000097:blood* / Q000276:immunology*; D011446:Prospective Studies
D015415:Biomarkers; D015850:Interleukin-6