Cord blood interleukin-6 and neonatal morbidities among preterm infants with PCR-positive Ureaplasma urealyticum

J Matern Fetal Neonatal Med. 2012 Oct;25(10):2106-10. doi: 10.3109/14767058.2012.678435. Epub 2012 May 3.

Abstract

Objectives: To evaluate the clinical significance of Ureaplasma urealyticum recovery from umbilical cord blood, using Polymerase Chain Reaction (PCR), and its association with umbilical cord interleukin-6 (IL-6) levels and neonatal morbidity in preterm infants.

Methods: Cord blood PCR for Ureaplasma urealyticum, and IL-6 were assessed in relation to neonatal outcomes of 30 preterm deliveries of less than 35 weeks' gestation.

Results: Ureaplasma urealyticum was present in 43.3% of the examined cord blood samples. Positive neonatal Ureaplasma urealyticum was more common in association with premature rupture of membranes, chorioamnionitis, antenatal maternal use of antibiotics, and earlier gestation. Ureaplasma urealyticum was also associated with an early pro-inflammatory immune response (i.e. elevated IL-6 and positive C-reactive protein). Cutoff level of interleukin-6 of 240 pg% predicts the occurrence of respiratory distress syndrome (RDS), in neonates with positive PCR for Ureaplasma urealyticum.

Conclusions: Preterm patients with positive cord blood PCR for Ureaplasma urealyticum were more likely to have premature rupture of membrane, antenatal antibiotics, chorioamnionitis, earlier gestation, pro-inflammatory response, and RDS than those with a negative PCR. High IL-6 is more likely associated with RDS in Ureaplasma urealyticum positive neonates.

MeSH terms

  • Biomarkers / blood
  • DNA, Bacterial / analysis
  • Female
  • Fetal Blood* / immunology
  • Fetal Blood* / microbiology
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / diagnosis
  • Infant, Premature, Diseases / etiology
  • Infant, Premature, Diseases / immunology
  • Infant, Premature, Diseases / microbiology*
  • Interleukin-6 / blood*
  • Male
  • Polymerase Chain Reaction
  • Prospective Studies
  • ROC Curve
  • Respiratory Distress Syndrome, Newborn / diagnosis
  • Respiratory Distress Syndrome, Newborn / immunology
  • Respiratory Distress Syndrome, Newborn / microbiology
  • Risk Factors
  • Sepsis / diagnosis
  • Sepsis / etiology
  • Sepsis / immunology
  • Sepsis / microbiology*
  • Ureaplasma Infections* / diagnosis
  • Ureaplasma Infections* / etiology
  • Ureaplasma Infections* / immunology
  • Ureaplasma urealyticum / genetics
  • Ureaplasma urealyticum / isolation & purification*

Substances

  • Biomarkers
  • DNA, Bacterial
  • Interleukin-6