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Published on: August 7, 2017
Elevated Interleukin-6 Levels as a Potential Marker of Neonatal Morbidity in Full-term Infants With Polycythemia: A
Reyhan Tamer1, Şerife Suna Oğuz Ünal2, Can Yilmaz Yozgat3
1Department of Developmental Pediatrics, Acibadem District Medipol Hospital, Istanbul.
Insights
Interleukin-6 (IL-6) levels are significantly higher in newborns with polycythemia, indicating a correlation with elevated venous hematocrit. C-reactive protein (CRP) did not show a significant association with polycythemia in this study.
Area of Science:
- Neonatalogy
- Biochemistry
- Pediatric Hematology
Background:
- Interleukin-6 (IL-6) and C-reactive protein (CRP) are established infection markers.
- Elevated IL-6 and CRP levels are observed in newborns admitted to the NICU for various reasons.
- The relationship between these markers and polycythemia in neonates requires further investigation.
Purpose of the Study:
- To investigate whether interleukin-6 (IL-6) and C-reactive protein (CRP) levels are elevated in newborns diagnosed with polycythemia.
- To determine the correlation between IL-6 and CRP levels and venous hematocrit (v. Hct) values in neonates.
Main Methods:
- A case-control study was conducted in a neonatal intensive care unit.
- Infants with gestational age >37 weeks were included; those with chorioamnionitis, perinatal asphyxia, or positive blood cultures were excluded.
- Blood samples were analyzed for central hematocrit, IL-6, and CRP levels six hours post-delivery. Polycythemia was defined as v. Hct >65%.
Main Results:
- Newborns with polycythemia (n=18) exhibited significantly higher IL-6 levels compared to the control group (n=17) (37.6 ± 55 vs 6.3 ± 3.4 pg/dL, P=0.00).
- IL-6 levels in the polycythemia group were also higher than established normal limits (12 ± 5 pg/dL, P=0.00).
- While CRP levels were slightly higher in the polycythemia group, the difference was not statistically significant (3.06 ± 4.07 vs 1.54 ± 2.21 mg/dL, P>0.05).
Conclusions:
- A significant positive correlation was found between IL-6 levels and venous hematocrit (v. Hct) values (rs = 0.641, P = 0.01).
- No significant relationship was observed between CRP levels and v. Hct values (rs = 0.184, P = 0.286).
- Elevated IL-6 may serve as an indicator in neonatal polycythemia, distinct from its role as a general infection marker.
Objective:
To research and show that interleukin-6 (IL-6) and c-reactive protein (CRP), which can be used as infection markers, are also higher among newborns with polycythemia. The study took place in the neonatal intensive care unit of Zekai Tahir Burak Maternity Teaching and Research Hospital.
Patients And Methods:
Infants with a gestational age of >37 weeks were included in the study. Infants with chorioamnionitis, perinatal asphyxia, and positive blood culture were excluded from the study. Blood samples were obtained six hours after the delivery from the peripheral vein of the infants for measurements of central hematocrit, blood culture, IL-6, and CRP. Infants with a venous hematocrit value of >65% were grouped as the "polycythemia group," and the ones with a venous hematocrit value of <65% were designated as the "control group." Observation of significantly higher levels of CRP and IL-6 among newborns admitted to the neonatal intensive care unit due to different causes (such as respiratory distress, hypoglycemia, and feeding intolerance), but significantly higher IL-6 levels in newborns with polycythemia.
Results:
Thirty-five newborns (18 infants in the polycythemia group and 17 infants in the control group) were enrolled in the study. The IL-6 values for the polycythemia group were higher than the upper normal limits (mean ± 2SD, 37.6 ± 55 vs 12 ± 5 pg/dL, respectively; P = 0.00). The IL-6 values of the polycythemia group were found to be higher than the IL-6 values of the control group, with a mean ± 2SD of 37.6 ± 55 vs 6.3 ± 3.4 pg/dL, respectively; this was significant ( P = 0.00). Although the CRP values of the polycythemia group were found to be slightly higher than those of the control group (a mean ± 2SD of 3.06 ± 4.07 vs 1.54 ± 2.21 mg/dL, respectively, P > 0.05), this was not significant.
Conclusions:
This study found a significant and robust statistical correlation between IL-6 and v. Hct values ( P = 0.01, rs = 0.641). Contrary to IL-6 levels, however, a meaningful relationship was not found between CRP and v.htc values ( P = 0.286; rs = 0.184).
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