Intraamniotic inflammation and umbilical cord blood interleukin-6 concentrations in pregnancies complicated by preterm prelabor rupture of membranes

J Matern Fetal Neonatal Med. 2017 Apr;30(8):900-910. doi: 10.1080/14767058.2016.1197900. Epub 2016 Jun 20.

Abstract

Objective: To evaluate umbilical cord blood interleukin (IL)-6 concentrations and the occurrence of fetal inflammatory response syndrome (FIRS) with respect to microbial invasion of the amniotic cavity (MIAC) and/or intraamniotic inflammation (IAI) in pregnancies complicated by preterm prelabor rupture of membranes (PPROM).

Methods: One-hundred-eighty-eight women with singleton pregnancies complicated by PPROM between gestational ages of 24 + 0 and 36 + 6 weeks were included in the study. Blood samples were obtained by venipuncture from the umbilical cord after the delivery of the newborn. The umbilical cord blood IL-6 concentrations were evaluated using ELISA kits. FIRS was defined as umbilical cord blood IL-6 > 11 pg/mL.

Result: Women with MIAC and IAI had higher IL-6 concentrations than women without these complications (with MIAC: median 18.1 pg/mL versus without MIAC: median 5.8; p < 0.0001; with IAI: median 32.9 pg/mL, versus without IAI: median 5.8; p < 0.0001). Women with IAI with MIAC and women with IAI without MIAC had the highest umbilical cord blood IL-6 concentrations (medians: 32.6 and 39.4 pg/mL) and rates of FIRS (78% and 67%).

Conclusions: IAI was associated with the highest umbilical cord blood IL-6 concentrations and rate of FIRS independent of the presence or absence of MIAC.

Keywords: Cytokines; fetal inflammatory response; intraamniotic inflammation; preterm delivery.

MeSH terms

  • Adult
  • Amniotic Fluid / chemistry*
  • Amniotic Fluid / metabolism
  • Chorioamnionitis / blood*
  • Female
  • Fetal Blood / chemistry*
  • Fetal Membranes, Premature Rupture / blood*
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Interleukin-6 / analysis*
  • Interleukin-6 / blood*
  • Pregnancy
  • Pregnancy Complications, Infectious / blood
  • Retrospective Studies

Substances

  • IL6 protein, human
  • Interleukin-6