Cord blood interleukin-6 as a predictor of early-onset sepsis in preterm babies

Abstract

Background Despite extensive investigation, no single test meets the criteria that could make it an ideal marker for early diagnosis of sepsis in the newborn. Generally, screening includes a complete blood count with differential white blood cell count and may be accompanied by other adjuvant tests such as evaluation of C-reactive protein. Objective The aim of the study was to evaluate the role of cord blood interleukin-6 (IL-6) as an early predictor of early-onset neonatal sepsis in preterm babies. Patients and methods We studied 75 preterm babies with risk factors of early-onset sepsis in Benha University Hospitals and measured IL-6 in cord blood samples to correlate them with C-reactive protein, hemoglobin percentage, white blood cells count with immature/total (I/T) ratio, and platelet count. Patients were classified into three groups according to gestational age and subdivided according to sepsis state into proven sepsis group (12 cases), probable sepsis group (48 cases) and noninfected group (15 cases). Samples were taken from the patients early just after birth in the resuscitation room. Statistical analysis The collected data were coded, tabulated and statistically analysed using SPSS (Statistical Package for Social Sciences), version 18.0. Results were considered significant if P value is less than 0.05 and highly significant if P value is less than 0.01. Results In our study, cord blood IL-6 was significantly higher in the septic group (probable and proven) with median 371.92 and 124.85 pg/ml, respectively, than in the noninfected group, with median 8.53 pg/ml ( P < 0.0001). The best cutoff level for IL-6 to diagnose neonatal sepsis is 47.5 pg/ml, with sensitivity 98.3% and specificity 93.3%. Conclusion Cord blood IL-6 can be used as a predictor of early-onset neonatal sepsis in preterm babies.