engleski

The evaluation of interleukine-6 and tumor necrosis factor-alpha value in umbilical cord blood as fetal response to chorioamnionitis

Aims: Early detection, especially of subclinical infection forms is extremely important concerning successful and timely treatment of affected newborns, as well as preventing any short and long term consequences. To evaluate the value of pro inflammatory cytokines IL-6 and TNF-alpha as new markers of early inflammatory responses to chorioamnionitis. Methods: Three groups of pregnant women were included: I-women with evident (lab and clinical) symptoms of chorioamnionitis II -women that were clinically healthy and had normal lab test results that started their deliveries by premature rupture of the membranes. III- a control group of healthy term pregnant women that went into spontaneous delivery. We have compared the IL-6 and TNF-alpha levels in the umbilical cord blood of newborns with histologically confirmed chorioamnionitis. IL-6 and TNF-alpha were measured by commercially available enzyme-linked immunosorbent assay. 101 pregnant women were included in the study, the first two groups containing 30 women, and the third containing 41 women. Results: Much higher levels of IL-6 were found in group I, with regard to the other two groups. The median was found to vary from 20.5 pg/mL in group I to 4 pg/mL in groups II and III (p=0.017 and p=0.0005). Significantly higher levels of TNF-alpha and IL-6 were found in the group of patients with histologically confirmed chorioamnionitis with regard to the group with negative pathohistological results. The TNF-alpha levels were statistically much higher in the first two groups when compared to the control group, median 17.5pg/mL in group I and II versus the median of 7 pg/mL in group III (p=0.019 and p=0.0001). Discussion: On the basis of previously elaborated evidence, we can conclude that both IL-6 and TNF-alpha correlate well with histologically identified chorioamnionitis. IL-6 is a reliable indicator of histologically proven fetal membrane inflammations in the group of pregnant women who have had clear clinical symptoms of the disease, while TNF-alpha proved to be a valuable prediction tool for early inflammatory response in the group with subclinical disease symptoms as well.

interleukine-6; tumor necrosis factor-alpha; chorioamnionitis

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