Cervical IL-6 and pIGFBP-1 and the prediction of neonatal outcome in symptomatic preterm labour.

OBJECTIVE: To evaluate the use of cervical Interleukin 6 (IL-6) and phosphorylated Insulin Growth Binding Protein 1 (pIGFBP1) in the prediction of adverse neonatal outcome.

METHODS: Prospective observational study including women between 24 and 34 weeks of gestation. One hundred and twelve cervical samples for IL-6 and pIFBP1 were taken. Neonatal outcome variables were birth weight, Apgar scores at 1st/5th minute, gestational age at delivery, admission to neonatal unit (NNU) and to neonatal intensive care unit (NICU), composite neonatal morbidity (NCM) and neonatal mortality.

RESULTS: Cervical IL-6 concentrations (pg/ml) were higher in neonates admitted to NNU and NICU versus non-admission, and women developing chorioamnionitis versus non-chorioamnionitis (mean ± standard deviation: 168.1 ± 205.2 versus 62.3 ± 72.4, p < 0.01; 262.1 ± 298 versus 92 ± 127.6, p < 0.01, and 564 ± 213 versus 93.4 ± 126.4, p < 0.05, respectively). In the NCM group, the IL-6 concentrations were higher compared to the non-NCM (181.7 ± 224 versus 84.1 ± 117.7, p < 0.05). In the preterm births <37 weeks, no differences were found for NCM, admission to NICU/NNU. The logistic regression analysis, showed cervical IL-6 and examination-to-delivery interval as predictors of NCM in the univariate analysis. However, the only independent marker of adverse neonatal outcome was the examination-to-delivery interval.

CONCLUSIONS: Adverse neonatal outcome is associated with increased cervical IL-6 concentrations.