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Morbidity in preterm infants with fetal inflammatory response syndrome
Elif Ozalkaya1, Güner Karatekin2, Sevilay Topcuoğlu2
1Zeynep Kamil Maternity and Children's Training Hospital, Istanbul, Turkey. elifozalkay@gmail.com.
Insights
High umbilical cord blood interleukin-6 (IL-6) levels in premature infants with fetal inflammatory response syndrome (FIRS) predict serious complications, including respiratory distress syndrome (RDS), death, and multiple organ failure (MOF). These findings highlight IL-6 as a critical biomarker for neonatal outcomes.
Area of Science:
- Neonatal Medicine
- Immunology
- Perinatal Research
Background:
- Fetal inflammatory response syndrome (FIRS) is associated with adverse outcomes in premature infants.
- Interleukin-6 (IL-6) is a key inflammatory marker.
- The predictive value of umbilical cord blood IL-6 for neonatal morbidity and mortality in FIRS requires further investigation.
Purpose of the Study:
- To evaluate the relationship between umbilical cord blood IL-6 concentration and preterm morbidity and mortality in premature infants with FIRS.
- To determine critical IL-6 thresholds for predicting specific adverse outcomes.
Main Methods:
- Prospective, observational study of 84 preterm infants (24-36 weeks gestational age).
- FIRS defined as umbilical cord blood IL-6 > 11 pg/mL.
- Evaluation of morbidities (RDS, MOF, etc.) and mortality in infants with FIRS.
Main Results:
- Infants with FIRS (IL-6 > 11 pg/mL) had significantly higher rates of RDS, MOF, and mortality.
- Umbilical cord blood IL-6 > 26.7 pg/mL predicted RDS (70% sensitivity, 85% specificity).
- Umbilical cord blood IL-6 > 37.7 pg/mL predicted death (78.6% sensitivity, 60% specificity).
- Umbilical cord blood IL-6 > 17.5 pg/mL predicted MOF (91% sensitivity, 66% specificity).
Conclusions:
- Elevated umbilical cord blood IL-6 levels in FIRS are predictive of significant neonatal morbidities and mortality.
- Specific IL-6 thresholds can identify premature infants at high risk for RDS, death, and MOF.
Background:
The aim of this study was to evaluate the relationship between umbilical cord blood interleukin (IL)-6 concentration and preterm morbidity and mortality in premature infants born with fetal inflammatory response syndrome (FIRS).
Methods:
This prospective, observational study included 84 preterm infants with a gestational age of 24-36 weeks who had been admitted to the neonatal intensive care unit (NICU). FIRS was defined as umbilical cord blood IL-6 > 11 pg/mL. In premature infants with FIRS, morbidities (multiple organ failure [MOF], respiratory distress syndrome [RDS], patent ductus arteriosus, intraventricular hemorrhage, bronchopulmonary dysplasia, retinopathy of prematurity) and death were evaluated. Critical umbilical cord blood IL-6 concentrations for the development of RDS, death, and for MOF were determined in premature infants with FIRS.
Results:
Fifty-two infants with IL-6 concentration > 11 pg/mL constituted the FIRS group. Thirty-two infants without FIRS served as a control group. RDS, MOF, and mortality were significantly higher in the FIRS group (P = 0.001, P = 0.001, and P = 0.005, respectively). Umbilical cord blood IL-6 concentration > 26.7 pg/mL in the FIRS group was found to be predictive of RDS, with 70% sensitivity and 85% specificity. Umbilical cord blood IL-6 concentration > 37.7 pg/mL was found to be predictive of death, with 78.6% sensitivity and 60% specificity. The predictive value of IL-6 for the development of MOF was 17.5 pg/mL, with 91% sensitivity and 66% specificity.
Conclusions:
Umbilical cord blood IL-6 concentration > 26.7, 37.7, and 17.5 pg/mL in premature infants with FIRS was found to be predictive for RDS, death, and MOF, respectively.
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