Document Detail


Umbilical vein interleukin 6 and tumor necrosis factor alpha plasma concentrations in the very preterm infant.
MedLine Citation:
PMID:  10749467     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the relationship between umbilical vein plasma concentrations of interleukin 6 (IL-6) and tumor necrosis factor (TNF)-alpha and early neonatal sepsis in the very preterm infant, and the histopathologic findings of chorioamnionitis in the placentas from these pregnancies. METHODS: A prospective study was conducted in 43 very preterm, singleton infants delivered at or before 32 weeks of gestation. IL-6 and TNF-alpha were measured by enzyme-linked immunoassay. Placentas from these pregnancies were histologically examined for the presence of chorioamnionitis. Infants were prospectively classified as confirmed sepsis group, clinical sepsis group or control group. IL-6 and TNF-alpha plasma concentrations were not normally distributed, so they were transformed to their natural log values for statistical analysis. RESULTS: The enrolled infants had a mean gestational age of 27.2 +/- 2.7 weeks and a mean birth weight of 956 +/- 325 g. Three (7%) infants had confirmed sepsis, 18 (42%) were in the clinical sepsis group and 22 (51%) were in the control group. IL-6 concentrations but not TNF-alpha were significantly higher (P < 0.05) in the confirmed (8.9 +/- 1.7) and clinical sepsis (5.5 +/- 2.4) groups in comparison with the control group (2.1 +/- 1.6). We examined 42 placentas. Twenty-three (55%) had no evidence of chorioamnionitis, 1 (2%) had mild grade, 8 (19%) had a moderate grade and 10 (24%) had a severe grade of chorioamnionitis. IL-6 was significantly elevated in the moderate (5.9 +/- 1.6 vs. 1.9 +/- 1.6) and severe grade (7.2 +/- 2.3 vs. 1.9 +/- 1.6) of chorioamnionitis, in the presence of acute deciduitis (6.0 +/- 2.7 vs. 2.1 +/-1.8), chorionic vasculitis (6.8 +/- 2.1 vs. 2.2 +/- 1.9) and funisitis (7.3 +/- 1.9 vs. 2.7 +/- 2.3) (P < 0.05) TNF-alpha plasma concentrations were not significantly different. CONCLUSION: An elevated umbilical vein IL-6 concentration is a good indicator of sepsis syndrome in the very preterm infant and also correlates with histologic chorioamnionitis in these pregnancies.
Authors:
F Kashlan; J Smulian; S Shen-Schwarz; M Anwar; M Hiatt; T Hegyi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  19     ISSN:  0891-3668     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-05-10     Completed Date:  2000-05-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  238-43     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, University of Medicine and Dentistry of New Jersey, UMDNJ-Robert Wood Johnson Medical School, St. Peter's University Hospital, New Brunswick, NJ 08903, USA. kashlafa@umdnj.edu
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MeSH Terms
Descriptor/Qualifier:
Blood Cell Count
Chorioamnionitis / diagnosis
Female
Fetal Blood / immunology*
Gestational Age
Humans
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / classification,  diagnosis*
Interleukin-6 / blood*
Predictive Value of Tests
Pregnancy
Prospective Studies
ROC Curve
Risk Factors
Sepsis / classification,  diagnosis*
Severity of Illness Index
Tumor Necrosis Factor-alpha / analysis*
Umbilical Veins
Chemical
Reg. No./Substance:
0/Interleukin-6; 0/Tumor Necrosis Factor-alpha

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