Related Experiment Video
Updated: Jun 11, 2025
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Predictive value of serum interleukin-6 for neonatal encephalopathy outcomes
Junichi Saito1, Jun Shibasaki1, Kouji Yamamoto2
1Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan.
Insights
Serum interleukin-6 (IL-6) levels on day 1 of life can predict death in neonatal encephalopathy (NE) patients. However, IL-6 shows limited utility in predicting neurodevelopmental disability without death in NE survivors.
Area of Science:
- Neonatal Medicine
- Neuroscience
- Biomarkers
Background:
- Serum interleukin-6 (IL-6) is a potential biomarker for adverse outcomes in neonatal encephalopathy (NE).
- Limited data exist on the predictive value of IL-6 during neurodevelopmental follow-up.
- This study investigates IL-6's utility in predicting outcomes at 18-22 months of age.
Purpose of the Study:
- To evaluate the predictive capability of serum IL-6 levels for adverse outcomes in neonatal encephalopathy.
- To assess the utility of IL-6 in predicting death and neurodevelopmental disability at 18-22 months postnatally.
Main Methods:
- Eighty-seven neonates with NE treated with therapeutic hypothermia were enrolled.
- Serial serum IL-6 levels were measured during the first three postnatal days.
- Outcomes at 18-22 months were categorized as death, moderate to severe neurodevelopmental disability (NDD), or favorable outcome.
Main Results:
- Eighty patients' IL-6 data were analyzed; levels peaked on day 1 and decreased by day 3.
- Higher day 1 IL-6 levels predicted a composite adverse outcome (death or NDD) with an AUC of 0.648.
- Higher day 1 IL-6 levels predicted death (AUC, 0.799) but showed lower predictive ability for NDD (AUC, 0.536).
Conclusions:
- Serum IL-6 on postnatal day 1 is a significant predictor of mortality in neonatal encephalopathy.
- The predictive utility of IL-6 for neurodevelopmental disability alone is insufficient.
- Further research may be needed to identify reliable biomarkers for predicting NDD in NE survivors.
Abstract:
Background: Serum interleukin-6 (IL-6) may predict adverse outcomes of neonatal encephalopathy (NE); however, limited data regarding the predictive utility of IL-6 during neurodevelopmental follow-up are available. We aimed to determine the utility of IL-6 for predicting adverse outcomes at 18 to 22 months of age.Methods: Eighty-seven patients with NE who received therapeutic hypothermia were enrolled in this study. Serial serum IL-6 levels during the first 3 postnatal days were collected. Patients were classified into three groups: (1) death, (2) survival with moderate to severe neurodevelopmental disability (NDD) at 18-22 months of age, and (3) survival without NDD (favorable outcome). The predictive ability of IL-6 was determined by the area under the receiver-operating characteristic curve (AUC).Results: Serial IL-6 data of 80 patients with NE were available and showed peak levels on postnatal day 1; these levels gradually decreased toward day 3. By 18-22 months of age, 13 and 17 patients died and experienced moderate to severe NDD without death, respectively. Fifty patients experienced favorable outcomes. Higher IL-6 levels on day 1 predicted the composite adverse outcome (including death and survival with NDD; n = 30; AUC, 0.648). Higher IL-6 levels on day 1 predicted death (n = 13; AUC, 0.799), whereas higher IL-6 levels on day 1 predicted survival with NDD (n = 17; AUC, 0.536).Conclusions: The AUC of IL-6 that predicted survival with NDD was lower than the AUC of IL-6 that predicted death; therefore, IL-6 may have insufficient utility for predicting NDD without death.
