BACKGROUND: In cases of premature rupture of membranes (PROM), an early detection of fetal infection is necessary in order to weigh infectious complications against prematurity. As routine parameters (leukocytes, C-reactive protein (CRP), fever, and fetal tachycardia) lack satisfactory sensitivity and specificity, this study evaluates whether the determination of interleukin-6 (IL-6), interleukin-8 (IL-8) or soluble interleukin-2 receptor (IL-2R) in maternal serum could supplement or replace routine inflammation parameters. METHODS: In this prospective study results of clinical and laboratory parameters were investigated with respect to neonatal infection in 71 patients with PROM. IL-6, IL-8 and IL-2R were determined by enzyme immunoassays. RESULTS: Best specificity and sensitivity could be demonstrated for CRP and IL-6. Both elevation of CRP and IL-6 correlated significantly (p<0.01 and p<0.001, respectively) with the onset of neonatal infection. At a cutoff of 11 pg/ml, IL-6 reaches a sensitivity of 81% and a specificity of 76%; CRP a specificity of 76% (cutoff 1.2 mg/dl) and a sensitivity of 56%. In 4/16 (25%) cases developing neonatal infection, IL-6 increased earlier than CRP. IL-8 and IL-2R results showed a less significant correlation with fetal outcome. CONCLUSIONS: Determination of IL-6 in maternal serum can significantly contribute to an earlier detection of fetal infection in patients with PROM.
BACKGROUND: In cases of premature rupture of membranes (PROM), an early detection of fetal infection is necessary in order to weigh infectious complications against prematurity. As routine parameters (leukocytes, C-reactive protein (CRP), fever, and fetal tachycardia) lack satisfactory sensitivity and specificity, this study evaluates whether the determination of interleukin-6 (IL-6), interleukin-8 (IL-8) or soluble interleukin-2 receptor (IL-2R) in maternal serum could supplement or replace routine inflammation parameters. METHODS: In this prospective study results of clinical and laboratory parameters were investigated with respect to neonatal infection in 71 patients with PROM. IL-6, IL-8 and IL-2R were determined by enzyme immunoassays. RESULTS: Best specificity and sensitivity could be demonstrated for CRP and IL-6. Both elevation of CRP and IL-6 correlated significantly (p<0.01 and p<0.001, respectively) with the onset of neonatal infection. At a cutoff of 11 pg/ml, IL-6 reaches a sensitivity of 81% and a specificity of 76%; CRP a specificity of 76% (cutoff 1.2 mg/dl) and a sensitivity of 56%. In 4/16 (25%) cases developing neonatal infection, IL-6 increased earlier than CRP. IL-8 and IL-2R results showed a less significant correlation with fetal outcome. CONCLUSIONS: Determination of IL-6 in maternal serum can significantly contribute to an earlier detection of fetal infection in patients with PROM.
Authors: Brian M Mercer; Dennis T Crouse; Robert L Goldenberg; Menachem Miodovnik; Delicia C Mapp; Paul J Meis; Mitchell P Dombrowski Journal: Am J Obstet Gynecol Date: 2011-09-08 Impact factor: 8.661
Authors: Yoram Sorokin; Roberto Romero; Lisa Mele; Ronald J Wapner; Jay D Iams; Donald J Dudley; Catherine Y Spong; Alan M Peaceman; Kenneth J Leveno; Margaret Harper; Steve N Caritis; Menachem Miodovnik; Brian M Mercer; John M Thorp; Mary Jo O'Sullivan; Susan M Ramin; Marshall W Carpenter; Dwight J Rouse; Baha Sibai Journal: Am J Perinatol Date: 2010-03-01 Impact factor: 1.862
Authors: Ivana Musilova; Lenka Pliskova; Romana Gerychova; Petr Janku; Ondrej Simetka; Petr Matlak; Bo Jacobsson; Marian Kacerovsky Journal: PLoS One Date: 2017-12-12 Impact factor: 3.240