Intraamniotic inflammation and umbilical cord blood interleukin-6 concentrations in pregnancies complicated by preterm prelabor rupture of membranes.
OBJECTIVE
To evaluate umbilical cord blood interleukin (IL)-6 concentrations and the occurrence of fetal inflammatory response syndrome (FIRS) with respect to microbial invasion of the amniotic cavity (MIAC) and/or intraamniotic inflammation (IAI) in pregnancies complicated by preterm prelabor rupture of membranes (PPROM).


METHODS
One-hundred-eighty-eight women with singleton pregnancies complicated by PPROM between gestational ages of 24 + 0 and 36 + 6 weeks were included in the study. Blood samples were obtained by venipuncture from the umbilical cord after the delivery of the newborn. The umbilical cord blood IL-6 concentrations were evaluated using ELISA kits. FIRS was defined as umbilical cord blood IL-6 > 11 pg/mL.


RESULTS
Women with MIAC and IAI had higher IL-6 concentrations than women without these complications (with MIAC: median 18.1 pg/mL versus without MIAC: median 5.8; p < 0.0001; with IAI: median 32.9 pg/mL, versus without IAI: median 5.8; p < 0.0001). Women with IAI with MIAC and women with IAI without MIAC had the highest umbilical cord blood IL-6 concentrations (medians: 32.6 and 39.4 pg/mL) and rates of FIRS (78% and 67%).


CONCLUSIONS
IAI was associated with the highest umbilical cord blood IL-6 concentrations and rate of FIRS independent of the presence or absence of MIAC.
a Department of Obstetrics and Gynecology , Faculty of Medicine, Charles University in Prague, Hradec Kralove, University Hospital Hradec Kralove , Hradec Kralove , Czech Republic.
Ivana
I
Musilova
b Department of Clinical Immunology and Allergy , Faculty of Medicine, Charles University in Prague, Hradec Kralove, University Hospital Hradec Kralove , Hradec Kralove , Czech Republic.
Ctirad
C
Andrys
b Department of Clinical Immunology and Allergy , Faculty of Medicine, Charles University in Prague, Hradec Kralove, University Hospital Hradec Kralove , Hradec Kralove , Czech Republic.
Marcela
M
Drahosova
b Department of Clinical Immunology and Allergy , Faculty of Medicine, Charles University in Prague, Hradec Kralove, University Hospital Hradec Kralove , Hradec Kralove , Czech Republic.
Ondrej
O
Soucek
a Department of Obstetrics and Gynecology , Faculty of Medicine, Charles University in Prague, Hradec Kralove, University Hospital Hradec Kralove , Hradec Kralove , Czech Republic.
Martin
M
Stepan
a Department of Obstetrics and Gynecology , Faculty of Medicine, Charles University in Prague, Hradec Kralove, University Hospital Hradec Kralove , Hradec Kralove , Czech Republic.
Tomas
T
Bestvina
c Department of Obstetrics and Gynecology , Faculty of Medicine, Ostrava University , Ostrava , Czech Republic.
Richard
R
Spacek
d Department of Obstetrics and Gynecology , Sahlgrenska Academy, Gothenburg University , Gothenburg , Sweden.|e Department of Genetics and Bioinformatics Area of Health Data and Digitalisation , Institute of Public Health , Oslo , Norway.
Bo
B
Jacobsson
d Department of Obstetrics and Gynecology , Sahlgrenska Academy, Gothenburg University , Gothenburg , Sweden.|f BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan De Deu), Fetal I + D Fetal Medicine Research Center, IDIBAPS, University of Barcelona , Barcelona , Spain.|g Center for Biomedical Research on Rare Diseases (CIBER-ER) , Barcelona , Spain , and.
Teresa
T
Cobo
a Department of Obstetrics and Gynecology , Faculty of Medicine, Charles University in Prague, Hradec Kralove, University Hospital Hradec Kralove , Hradec Kralove , Czech Republic.|h Biomedical Research Center, University Hospital Hradec Kralove , Hradec Kralove , Czech Republic.
Marian
M
Kacerovsky
D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry* / Q000378:metabolism; D002821:Chorioamnionitis / Q000097:blood*; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005322:Premature Rupture of Fetal Membranes / Q000097:blood*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D015850:Interleukin-6 / Q000032:analysis* / Q000097:blood*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood; D012189:Retrospective Studies
C508600:IL6 protein, human; D015850:Interleukin-6
Cytokines; fetal inflammatory response; intraamniotic inflammation; preterm delivery