ИНТЕРЛЕЙКИН-6 КАК ИНДИКАТОР ТЯЖЕСТИ ПОЛИОРГАННОЙ НЕДОСТАТОЧНОСТИ У НЕДОНОШЕННЫХ ДЕТЕЙ С МАССОЙ ТЕЛА МЕНЕЕ 1500 г: РЕТРОСПЕКТИВНОЕ КОГОРТНОЕ ИССЛЕДОВАНИЕ

Abstract

Multiple organ dysfunction syndrome (MODS), or multiple organ system failure (MOSF), or multiple organ failure (MOF) in children in the early neonatal period is usually developing against the background of severe birth asphyxia and/or hypoxemia due to various causes (e.g., against the background of critical congenital heart disease) or an infectious process, being one of the main and most frequent reasons for the poor outcome. The level of Interleukin-6 (IL-6) is considered the earliest biomarker for the presence of an infectious process in newborns. The relationship between the level of IL-6 in the blood of premature newborns and the severity of MOF has not been studied enough as yet. The purpose of this research was to study the relationship between the level of IL-6 in the blood and the severity of MOF in premature newborns with a birth weight (BW) of less than 1500 grams in the early neonatal period. Materials and methods used: a single-center retrospective cohort study was conducted in May 26 - September 26, 2022 on the basis of L.A. Vorokhobov Moscow City Clinical Hospital No. 67 of the Moscow Department of Healthcare (located in Moscow, Russia). All of the patients had been followed-up since birth until the discharge from the hospital. Authors have included premature infants with birth weight of less than 1500 grams, gestational age (GA) of less than 32 weeks, with MOF, who were determined by the level of IL-6 in blood serum by high-precision immunochemiluminescent analysis in the first 24 hours and 72 hours of life. Children with severe congenital developmental anomalies, chromosomal and/or genetic syndromes were excluded. Results: a total of 86 preterm infants were included. The patients were divided into 2 groups: G1 of 49 with IL-6<30 pg/ml, and G2 of 37 with IL-6≥30 pg/ml. The groups were identical in terms of gender, BW, GA, height, and the APGAR score. In G2 the premature rupture of amniotic fluid was more common - 6 (12.0%) vs. 15 (41.0%), p=0.005; there were fewer children on non-invasive mechanical ventilation - 15 (31.0%) vs. 3 (8.0%), p=0.015; NEOMOD MOF severity score was higher - 2.0 [1.0; 3.0], (n=47) vs. 3.0 [2.0; 6.0], (n=37), p=0.001; modified inotropic index by the 3rd day of life significantly prevailed - 3.0 [2.0; 5.0], (n=13) vs. 25.5 [19.0; 77.5], (n=12); p=0.001. The average level of IL-6 in G2 was significantly higher on the first day of life and amounted to 121.0 [71.6; 188.0] pg/ml vs. 13.95 [8.79; 17.52] pg/ml in G1; p<0.001. Conclusion: the level of IL-6 of more than 30 pg/ml in the blood of premature newborns with BW of less than 1500 grams in the first 24 hours of life can be considered as an indicator for the MOF severity.