Comparison of markers for fetal inflammatory response syndrome: fetal blood interleukin-6 and neonatal urinary beta(2)-microglobulin.
OBJECTIVE
Chronic lung disease (CLD) is a major component in the morbidity of premature infants suffering from fetal inflammatory response (FIRS). The aim of the present study was to compare the value of measuring neonatal urinary beta(2)-microglobulin (beta(2)-MG) levels with fetal blood interleukin (IL)-6 levels in premature infants at risk of developing CLD.


METHODS
Premature infants (gestational age <30 weeks) without CLD (n = 19) and with CLD (n = 10) were enrolled. We measured IL-6 levels in umbilical cord blood and beta(2)-MG levels in urine obtained within 48 h after birth.


RESULTS
IL-6 and beta(2)-MG levels were significantly higher in infants who developed CLD than in those who did not (median IL-6, 54.7 vs 7.6 pg/mL; P < 0.005; beta(2)-MG 17.7 vs 9.3 x 10(4) microg/gCr; P < 0.05). The sensitivity and negative predictive value of beta(2)-MG at the cut-off value at 10.0 x 10(4) microg/gCr (0.90 and 0.92) were comparable to IL-6 at 16 pg/mL (0.90 and 0.94).


CONCLUSIONS
We suggest that measuring urinary beta(2)-MG in premature infants soon after birth can monitor FIRS and may provide information on the risk of subsequent CLD development that is as clinically important as information derived from umbilical cord blood IL-6.
Nishimaki
Shigeru
S
Department of Pediatrics, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan. shigenis@med.yokohama-cu.ac.jp
Sato
Miho
M
An
Hiromi
H
Shima
Yoshio
Y
Akaike
Toru
T
Yokoyama
Utako
U
Yokota
Shumpei
S
D015415:Biomarkers / Q000032:analysis*; D002908:Chronic Disease; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005315:Fetal Diseases / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000097:blood / Q000652:urine; D015850:Interleukin-6 / Q000097:blood*; D008171:Lung Diseases / Q000097:blood / Q000209:etiology / Q000652:urine; D011247:Pregnancy; D012307:Risk Factors; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications / Q000175:diagnosis / Q000196:embryology*; D001613:beta 2-Microglobulin / Q000652:urine*
D015415:Biomarkers; D015850:Interleukin-6; D001613:beta 2-Microglobulin