The value of cord blood interleukin-6 levels for predicting chorioamnionitis, funisitis and neonatal infection in term premature rupture of membranes

Eur J Obstet Gynecol Reprod Biol. 2006 Sep-Oct;128(1-2):34-9. doi: 10.1016/j.ejogrb.2005.11.049. Epub 2006 Feb 3.

Abstract

Objective: The objective was to determine whether the interleukin-6 (IL-6) level in umbilical cord blood can be used for the prediction of histologic chorioamnionitis, funisitis, fetal membrane cultures and neonatal infection.

Study design: A case-control study was conducted on 30 controls (control group) and on 40 women with term premature rupture of the membranes (PROM group). The interleukin-6 concentration of cord blood was measured. Fetal membranes and newborn blood were cultured. Placentas were examined for histologic chorioamnionitis and funisitis. Receiver operator curve analysis was used to obtain a cut-off value of interleukin-6 concentration for predicting histological and clinical infection.

Results: The mean interleukin-6 level in cord blood was significantly higher in the PROM group (p=0.01). Histological chorioamnionitis and positive placental cultures were significantly higher in the PROM group (p=0.006 and 0.02, respectively). The PROM group had seven (17.5%) cases of funisitis and positive newborn blood cultures while neither was observed in the control group. A cord blood interleukin-6 level >29 pg/ml was found to have 84% sensitivity and 72.5% specificity for predicting positive placental cultures and 74.1% sensitivity and 76.7% specificity for identifying cases of histologic chorioamnionitis. For predicting funisitis and positive newborn cord blood cultures a cord blood interleukin-6 level >39 pg/ml has 100% sensitivity and 81% specificity.

Conclusion: Cord blood interleukin-6 level can be a tool for the evaluation of the extent of maternal-fetal infection and guides proper planning of the treatment.

MeSH terms

  • Adult
  • Chorioamnionitis / diagnosis
  • Chorioamnionitis / microbiology*
  • Female
  • Fetal Blood / immunology*
  • Fetal Blood / microbiology
  • Fetal Membranes, Premature Rupture / immunology
  • Fetal Membranes, Premature Rupture / microbiology*
  • Humans
  • Infant, Newborn
  • Infections / etiology
  • Interleukin-6 / blood*
  • Maternal-Fetal Exchange
  • Placenta / microbiology*
  • Placenta / pathology
  • Predictive Value of Tests
  • Pregnancy
  • ROC Curve
  • Sensitivity and Specificity

Substances

  • Interleukin-6