Il-1 beta, Il-6, Il-8 and G-CSF in the diagnosis of early-onset neonatal infections

Objective: To determine whether inflammatory cytokine concentrations (Il-1 beta, Il-6, Il-8 and G-CSF) in umbilical cord blood are useful predictors o f an early-onset neonatal infection. Material and methods: 240 women and their newborns were enrolled in our stu dy and umbilical cord blood samples collected from neonates (n = 240) were subjected to ELISA for Il-1 beta, Il-6, Il-8 and GCSF. Clinical outcome of the neonates was followed and documented. Placenta histology was also avail able in majority of the cases (n = 195). Results: Early-onset neonatal infection was diagnosed in 5.4 % of neonates ( 13/240) and placental examination showed histologic chorioamnionitis in 1 7.9 % (35/195). Both Il-1 beta and Il-6 cord blood concentrations were elev ated in association with histologic chorioamnionitis (Il-1 beta - 2.7 vs. 2 .1 pg/ml, p < 0.05 and Il-6 15.6 vs. 12.8 pg/ml, p < 0.005). Only Il-6 was elevated (16.0 vs. 13.2 pg/ml, p < 0.05) in neonates with early-onset bacte rial infections. ROC analysis showed acceptable diagnostic performance of I l-6 in the identification of acute histologic chorioamnionitis and clinical neonatal infection. Conclusion: Il-6 in umbilical cord blood seems to be a promising predictor for early-onset neonatal infections.