Cord blood TNF-α and IL-6 levels as diagnostic indicators of brain damage in neonates with non-asphyxia fetal distress.

PURPOSE: We investigated prospectively cord blood TNF-α and IL-6 levels as diagnostic indicators of brain damage in neonates with non-asphyxia fetal distress.

METHODS: Eighty neonates delivered by cesarean section from January 2013 to December 2014 were enrolled. Magnetic resonance imaging was conducted to determine brain damage. Neonates were assigned to a healthy control group (n = 30) or, with fetal distress, apportioned to groups with or without brain damage (n = 20 and 30, respectively). After delivery, the umbilical arterial blood of all neonates was harvested. Serum tumor necrosis factor-alpha (TNF-α) and interleukin 6 (IL-6) levels were evaluated to investigate a correlation between cord blood TNF-α and IL-6 levels and brain damage caused by non-asphyxia fetal distress.

RESULTS: The TNF-α and IL-6 levels in the cord blood of brain-damaged neonates with fetal distress (75.63 ± 7.68 and 217.95 ± 25.15 pg/mL, respectively) were significantly higher than that of neonates with fetal distress without brain damage (43.67 ± 5.54, 119.08 ± 12.30 pg/mL) or the healthy neonates (42.35 ± 6.63, 128.46 ± 16.15 pg/mL); the latter two groups were comparable for both TNF-α and IL-6. The receiver operating characteristic curve showed that when TNF-α (IL-6) reached 53.23 pg/mL (156.23 pg/mL), the specificity and sensitivity for diagnosis of brain damage was 80.3% (82.5%) and 90.1% (81.5%), respectively.

CONCLUSION: Monitoring TNF-α and IL-6 levels in umbilical cord blood may assist early diagnosis of brain damage in neonates with non-asphyxia fetal distress.