Cord Blood Interleukin 6 and Intrauterine Infection in Preterm Infant

ABSTRACT

PURPOSE: Our purpose was to examine the relationship between the intrauterine infection and the concentration of cord blood interleukin 6 in preterm infants. METHODS: Patients delivering preterm infants because of spontaneous preterm labor were evaluated for clinical signs of chorioamnionitis, which was defined as a temperature of >or=37.8 degrees C along with >or=2 of the followings Significant maternal tachycardia (>or= 100/min), fetal tachycardia (>or=160/min), purulent discharge, uterine tenderness, and leukocytosis (WBC >or=15,000c ells/mm3). Their placentas were examined for histologic chorioamnionitis. Cord blood was assayed for Interleukin 6 and CRP. And Interleukin 6 and CRP were sequentially determined at 12-24hour and at 36-48 hour. An elevated interleukin 6 was determined to be 20 pg/mL. Infants were evaluated for the evidences of early and late neonatal sepsis, respiratory distress syndrome, necrotizing enterocolitis, intraventricular hemorrhage, neonatal pneumonia, and bronchopulmonary dysplasia. RESULTS: Umbilical cord blood interleukin 6 was significantly higher in the presence of intrauterine infection than in the absence of intrauterine infection (208.4+/-426.3 pg/mL VS 13.3+/-20.6 pg/mL P=0.018). And the frequencies of histologic chorioamnionitis, early neonatal sepsis, neonatal pneumonia, and morbidity were significantly higher in the presence of intrauterine infection than in the absence of intrauterine infection (P=0.003, P=0.000, P=0.042, and P=0.000, respectively). There was significant difference in gestational age, but no significant differences in maternal age, parity, birth weight, method of delivery, respiratory destress syndrome, necrotizing enterocolitis, intraventricular hemorrhage, and bronchopulmonary dysplasia. Using receiver operator characteristic curves, the best cutoff for interleukin 6 was found to be 20 pg/mL. CONCLUSION: Cord blood interleukin 6 was significantly elevated in the intrauterine infection in the preterm infant.