Patterns of increases in interleukin-6 and C-reactive protein as predictors for white matter injury in preterm infants.
BACKGROUND
The aim of this study was to determine whether patterns of increases in serum interleukin-6 (IL-6) and C-reactive protein (CRP) levels at birth were associated with the development of white matter injury (WMI) in preterm infants with a fetal inflammatory response (FIR).


METHODS
One hundred infants who were born at <32 weeks gestation and had funisitis, as determined by histological evidence of FIR, were studied. Infants were divided into four groups according to IL-6 and CRP levels at birth, with cut-off values of 200 pg/mL and 0.4 mg/dL, respectively. We compared the incidence of WMI, determined by MRI at term-equivalent age, among these groups.


RESULTS
The number of infants in each group was 12, 43, 0, and 45 in the high IL-6 and high CRP (HH) group, high IL-6 and low CRP (HL) group, low IL-6 and high CRP (LH) group, and low IL-6 and low CRP (LL) group, respectively. The incidence of WMI was significantly higher in the HH group than in the HL group and LL group (83%, 40%, and 34%, respectively). Multiple logistic regression analysis revealed that a combined elevation in IL-6 and CRP levels was an independent predictor for the development of WMI (odds ratio, 8.3).


CONCLUSIONS
A combined elevation in serum IL-6 and CRP levels at birth was associated with the development of WMI in preterm infants with FIR.
Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center, Kobe, Japan.
Kei
K
Inomata
Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center, Kobe, Japan.
Masami
M
Mizobuchi
Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center, Kobe, Japan.
Satoshi
S
Tanaka
Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center, Kobe, Japan.
Sota
S
Iwatani
Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center, Kobe, Japan.
Hitomi
H
Sakai
Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center, Kobe, Japan.
Seiji
S
Yoshimoto
Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center, Kobe, Japan.
Hideto
H
Nakao
D002097:C-Reactive Protein / Q000378:metabolism*; D002821:Chorioamnionitis / Q000097:blood* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000097:blood* / Q000175:diagnosis; D015850:Interleukin-6 / Q000097:blood*; D007969:Leukomalacia, Periventricular / Q000097:blood* / Q000175:diagnosis; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D066127:White Matter / Q000293:injuries*
C508600:IL6 protein, human; D015850:Interleukin-6; D002097:C-Reactive Protein
C-reactive protein; interleukin-6; periventricular leukomalacia; premature infant; white matter injury