Background: High concentrations of interleukin-6 (IL-6) have been demonstrated
in amniotic fluid (AF) from women with intra-amniotic infection. Concentration
of IL-6 in cervical secretions in women with preterm labor and intact membranes was
found to be significantly correlated with AF IL-6 in cases of intra-amniotic infection,
Objective: To study the IL-6 levels in the cervical secretions in preterm deliveries
with intact membranes as a non invasive technique and correlating them with the
umbilical vein IL-6 levels and the risk of early onset neonatal sepsis.
Methods: Forty eight women in preterm labor (25 - 34 weeks gestation) with intact
membranes were included in the study. Cervical secretions were collected through
sterile speculum before rupture of membranes. Umbilical vein blood samples were
collected by vein puncture after birth. IL-6 concentrations were determined with
enzyme-linked immune assay. Early neonatal sepsis was diagnosed in the presence
of positive blood cultures within 72 hours after delivery.
Results: Thirteen newborns (27.1%) had early onset neonatal sepsis. Gestational age
less than 32 weeks was significantly more associated with early onset neonatal
sepsis. The mean cervical IL-6 concentrations were significantly correlated with
umbilical vein IL-6 concentrations and both were significantly correlated with the
occurrence of early onset neonatal sepsis (P <0.001). 1-6 concentrations of 200 pg/m1
or more in cervical secretions and 25 Wm! or more in umbilical vein blood had 71.2%
and 89.2% diagnostic accuracy in the prediction of early onset neonatal sepsis
respectively.
Conclusion: It is concluded that the measurement of I1-6 in the cervical secretions
together with umbilical vein IL-6 my help non invasively to identify the risk of early
onset neonatal sepsis among preterm deliveries with intact membranes. |
