Study of Interleukin-6 and Tumor Necrosis Factor-a Cord Blood Levels in Non-Infected Neonates with fetal Distress Delivered Vaginally and by Caesarean Section
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Interleukin-6 (IL-6) and tumor necrosis factor-a (TNF-a) are released in infected neonates, but some studies found that they are also released in non-infected neonates with fetal distress. Recently, particular attention is paid toward the proinflammatory cytokines IL-6 & TNF-a as new diagnostic parameters for fetal distress in non-infected neonates. This study aimed at finding the relation between proinflammatory cytokine (1L-6 & TNF-a) in non-infected neonates cord blood levels and fetal distress also, their relation to the presence or absence of labor and mode of delivery. This study was carried out in Benha University Maternity Hospital, from January to December 2005. It included 80 non-infected singleton neonates, 40 neonates delivered vaginally (15 with fetal distress where labor is present in 10 deliveries and 25 without fetal distress where labor is present in 17 deliveries), and 40 neonates delivered by cesarean section (28 with fetal distress where labor is present in 16 deliveries and 12 without fetal distress where labor is present in 8 deliveries). Cord blood samples were collected aseptically immediately after delivery and used for measuring the levels of circulating mediators (TNF-a and IL-6). Those samples showing criteria of infection are excluded The results showed a significant increase in TNF-a in neonates born vaginally and by cesarean section (TNF-a - P-Value 0.018) but non-significant for IL-6 (IL-6 P-value 0.51). Neonates with fetal distress born vaginally had a significant high level of TNF-a (85.9 1 30.9 — P-value 0.001), and IL-6 (174.2 ± 87.1 — P-value 0.046), than those born by cesarean section. Neonates without fetal distress had a significant high level of TNF-a only (P-value 0.05). Neonate with fetal distress had a high significant value of TNF-a & IL-6 than those without fetal distress either born vaginally or by cesarean section, also the presence or absence of labor had no significant value on TNF-a and IL-6 in neonates irrespective of fetal distress or type of labor. It is concluded that neonates with fetal distress either born vaginally or by caesarean section had a high significant value of TNF-a and IL-6 cord blood levels and that, the presence or absence of labor had no effect on the value of both parameters.