Background. The aim of this study was to investigate whether the levels
of interleukin-6 (IL-6) can be used as markers of adverse outcome in
preterm neonates born after preterm premature rupture of membranes
(PPROM).
Methods. This study involved 109 preterm neonates and their mothers. The
PPROM group consisted of 58 neonates who were born after PPROM, and the
control group consisted of 51 neonates. IL-6 levels were measured in
umbilical cord blood, maternal blood sampled during delivery and in
neonatal blood taken on the fourth day of life.
Results. In the PPROM group, IL-6 concentrations in maternal blood, cord
blood, and neonatal blood were significantly higher in neonates with
sepsis, compared with those without sepsis (P < 0.001). Choosing 108.5
pg/ml as a cut-off concentration of IL-6 in umbilical cord blood for
neonatal sepsis resulted in sensitivity 95%, specificity 100%,
positive predictive value 100%, and negative predictive value 97.4%.
Concerning IL-6 in maternal blood, a cut-off concentration of 81 pg/ml
showed sensitivity 90%, specificity 97.4%, positive predictive value
94.7%, and negative predictive value 94.9%. Eighteen of 20 neonates
with early sepsis and seven of nine neonates, who died in the PPROM
group, were born of mothers with IL-6 levels above the cut-off
concentration in their blood during delivery.
Conclusions. IL-6 in umbilical cord blood was the most significant
variable for predicting early onset sepsis in preterm neonates. IL-6 in
maternal blood was indicative of intrauterine environmental threats and
might be used to identify pregnancies where intervention would be
appropriate
