Abstract
ObjectiveTo evaluate umbilical cord interleukin (IL)-6 and funisitis as independent predictors of early-onset neonatal sepsis (EONS) in preterm prelabor rupture of membranes (PPROM).DesignProspective cohort study.SettingEvaluation of umbilical cord IL-6 and funisitis as predictors of early-onset neonatal sepsis in PPROM.Population176 women with PPROM between 23+0−36+6 weeks of gestation.MethodsUmbilical cord IL-6 was assayed by ELISA. Funisitis was defined according to the Salafia classification. Data was adjusted by gestational age at delivery and prenatal administration of corticosteroids and antibiotics.Main Outcome MeasuresBinary logistic regression was performed to assess the independence of umbilical cord IL-6 and funisitis to predict EONS in women complicated with PPROM.ResultsThe rate of EONS was 7%. Funisitis was present in 18% of women. Umbilical cord IL-6 was significantly higher in women complicated with EONS than without [median (range) 389.5 pg/mL (13.9–734.8) vs 5.2 (0.1–801–4), p<0.001]. Umbilical cord IL-6 was the only independent predictor of early-onset neonatal sepsis (odds ratio 13.6, p = 0.004).ConclusionUmbilical cord IL-6 was the only predictor of early-onset neonatal sepsis in PPROM. Contrary to what is reported, funisitis was not.
Highlights
Early-onset neonatal sepsis (EONS) is a serious complication with a mortality rate ranging from 1.5% in term to almost 40% in very-low-birth weight infants [1]
Umbilical cord IL-6 was significantly higher in women complicated with EONS than without [median 389.5 pg/mL (13.9–734.8) vs 5.2 (0.1–801–4), p,0.001]
Umbilical cord IL-6 was the only predictor of early-onset neonatal sepsis in prelabor rupture of membranes (PPROM)
Summary
Early-onset neonatal sepsis (EONS) is a serious complication with a mortality rate ranging from 1.5% in term to almost 40% in very-low-birth weight infants [1]. Neonatal symptoms and laboratory markers of neonatal sepsis may be indistinguishable from various non-infectious conditions. No currently available test is able to provide perfect diagnostic accuracy, and false-negative as well as false-positive results may occur. Empirical antibiotic therapy is current practice in all neonates with suspicion of EONS. Empirical treatment increases the exposure to adverse drug effects, nosocomial complications and a high risk to develop resistant strains. An early prediction of EONS could improve neonatal management of newborns complicated with EONS
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
