Maternal plasma interleukin-6, interleukin-1β and C-reactive protein as indicators of tocolysis failure and neonatal outcome after preterm delivery
Maternal plasma interleukin-6, interleukin-1β and C-reactive protein as indicators of tocolysis failure and neonatal outcome after preterm delivery
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DOI：
10.1080/14767050701227877
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发表时间：
2007-01-01
影响因子：
1.8
通讯作者：
Kalafatic, Drzislav
中科院分区：
文献类型：
--
作者：
Skrablin, Snjezana;Lovric, Helena;Kalafatic, Drzislav
目标。目的探讨孕妇血清白细胞介素-6 （IL-6）、白细胞介素-1 β (IL-1 β)和高敏c反应蛋白（CRP）水平是否可作为早产妊娠患者抗胎压失败和新生儿不良结局的指标。对47例产妇在入院及分娩时因早产而采血进行分析。对照样本取自20例正常妊娠孕妇。分析了绒毛膜羊膜炎、新生儿感染或心室周围白质软化（PVL）患者与非绒毛膜羊膜炎患者白细胞介素和CRP水平的差异。估计截断值用于预测胎溶失败和不良新生儿结局。早产患者的这三个参数明显高于足月分娩患者。组织学绒毛膜羊膜炎组（p < 0.001）、新生儿感染组（p < 0.01）、PVL组（IL-6和IL-1 β组p < 0.01， CRP组p < 0.05）、胎膜早破（PPROM）在48小时内分娩组（p < 0.01）的三个指标均显著高于未感染组（p < 0.001）。选择50.9 pg/mL的IL-6和19.7的CRP作为新生儿PVL的母体血液入院浓度的临界值，其敏感性为81%，特异性为91%，敏感性为91%，特异性为81%。产妇入院时IL-6和CRP的临界值分别为27.8 pg/mL和8.9 pg/mL，这两个参数都是新生儿感染的有效预测指标。母亲血液IL-6和CRP可用于预测胎儿的溶胎失败和宫内治疗。
Objective. To investigate whether maternal serum interleukin-6 (IL-6), interleukin-1 beta (IL-1 beta) and high sensitive C-reactive protein (CRP) could be used as markers of tocolysis failure and adverse neonatal outcome in pregnancies with preterm labor (PL).Methods. Forty-seven maternal blood samples taken because of PL at admission and delivery were analyzed. Control samples were taken from 20 gravidas with normal pregnancies. Differences in interleukins and CRP levels with or without chorioamnionitis, connatal infection or periventricular leukomalacia (PVL) were analyzed. Cut-off values were estimated for prediction of tocolysis failure and adverse neonatal outcome.Results. All three parameters were significantly higher in patients delivering prematurely than in patients delivering at term. All three parameters were significantly higher with than without histologic chorioamnionitis ( p < 0.001), with than without connatal infection (p < 0.01), with than without PVL (p < 0.01 for IL-6 and IL-1 beta, p < 0.05 for CRP), and in pregnancies with preterm premature rupture of membranes (PPROM) delivered within 48 hours compared to those more prolonged (p < 0.01). Choosing 50.9 pg/mL of IL-6 and a CRP of 19.7 as cut-offs in maternal blood admission concentrations for neonatal PVL, resulted in sensitivity of 81% and specificity of 91% and sensitivity of 91% and specificity of 81%, respectively. At respective maternal blood admission cut-off levels of 27.8 pg/mL of IL-6 and 8.9 of CRP, both parameters were effective predictors of connatal infection.Conclusions. Maternal blood IL-6 and CRP could become useful in predicting tocolysis failure and intrauterine treat for the fetus.