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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:
- Neonatal encephalopathy (NE) is a serious condition with potential long-term neurodevelopmental consequences.
- Serum interleukin-6 (IL-6) is a potential biomarker for adverse outcomes in NE.
- Limited data exist on the predictive value of IL-6 during the neurodevelopmental follow-up period.
Purpose of the Study:
- To investigate the utility of serial serum IL-6 levels in predicting adverse outcomes at 18-22 months of age in NE patients.
- To assess the predictive accuracy of IL-6 for death and neurodevelopmental disability (NDD) in NE survivors.
Main Methods:
- Eighty-seven NE patients treated with therapeutic hypothermia were enrolled.
- Serial serum IL-6 levels were measured during the first three postnatal days.
- Outcomes at 18-22 months included death, moderate to severe NDD, or favorable outcome (no NDD).
- Predictive ability was assessed using the area under the receiver-operating characteristic curve (AUC).
Main Results:
- Eighty NE patients had available IL-6 data, showing peak levels on day 1, decreasing by day 3.
- At 18-22 months, 13 patients died, 17 had moderate to severe NDD, and 50 had favorable outcomes.
- Higher day 1 IL-6 levels predicted the composite adverse outcome (death or NDD; AUC=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 day 1 is a significant predictor of mortality in neonatal encephalopathy.
- The predictive utility of IL-6 for neurodevelopmental disability in survivors is limited.
- IL-6 may be insufficient for predicting non-fatal neurodevelopmental disability in NE patients.
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.
