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Patterns of increases in interleukin-6 and C-reactive protein as predictors for white matter injury in preterm
Kei Inomata1, Masami Mizobuchi1, Satoshi Tanaka1
1Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center, Kobe, Japan.
Insights
Elevated serum interleukin-6 (IL-6) and C-reactive protein (CRP) levels at birth predict white matter injury (WMI) in preterm infants with fetal inflammatory response (FIR). This finding highlights key biomarkers for neonatal brain development risks.
Area of Science:
- Neonatalogy
- Biomarkers
- Neurodevelopmental Pediatrics
Background:
- Preterm infants with fetal inflammatory response (FIR) face risks for white matter injury (WMI).
- Serum inflammatory markers like interleukin-6 (IL-6) and C-reactive protein (CRP) are implicated in neonatal complications.
Purpose of the Study:
- To investigate the association between combined elevations in serum IL-6 and CRP levels at birth and the incidence of WMI.
- To identify predictive biomarkers for WMI in preterm neonates with evidence of FIR.
Main Methods:
- Studied 100 preterm infants (<32 weeks gestation) with histological evidence of FIR (funisitis).
- Classified infants into four groups based on serum IL-6 and CRP levels at birth.
- Assessed WMI using MRI at term-equivalent age and compared incidence across groups.
Main Results:
- The group with high IL-6 and high CRP (HH) showed a significantly higher incidence of WMI (83%) compared to other groups (40-34%).
- Combined elevation of IL-6 and CRP was identified as an independent predictor of WMI (OR, 8.3).
Conclusions:
- A combined elevation in serum IL-6 and CRP levels at birth is significantly associated with the development of WMI in preterm infants with FIR.
- These inflammatory markers may serve as crucial early indicators for WMI risk in vulnerable neonates.
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).
Conclusion:
A combined elevation in serum IL-6 and CRP levels at birth was associated with the development of WMI in preterm infants with FIR.
