Inflammatory and oxidative parameters in cord blood as diagnostic of early-onset neonatal sepsis: a case-control study.

OBJECTIVE

To determine whether levels of interleukin (IL)-6, IL-10, and oxidative parameters in umbilical cord blood could contribute as an indicator of neonatal sepsis in recognized high-risk neonates.

DESIGN

Prospective, case-control study.

SETTING

Neonatal intensive care unit.

SUBJECTS: One hundred twenty consecutive preterm neonates who had at least one other risk factor for early-onset neonatal sepsis.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN

RESULTS

Umbilical cord blood samples were obtained for the determination of IL-6, IL-10, thiobarbituric acid reactive substances (TBARS), and protein carbonyls levels. Neonates were divided prospectively in two groups: control and septic. All parameters were higher in septic patients compared with control (IL-6 184.6 +/- 72.7 vs. 58.9 +/- 19.1, p < 0.01; IL-10 171.4 +/- 59.2 vs. 79.9 +/- 17.9, p < 0.01; TBARS 10.1 +/- 2.8 vs. 4.2 +/- 2.5, p < 0.01; protein carbonyls 2.4 +/- 1.2 vs. 1.15 +/- 0.5, p < 0.01, respectively, septic vs. control). In addition, these parameters were higher in the subgroup of culture-positive septic patients compared with control. IL-6 and TBARS had equivalent areas under the receiver operator characteristic (ROC) curve (0.88); IL-10 (0.80) and protein carbonyls (0.73) had lower areas. Multivariate logistic regression comparing IL-6 and TBARS in terms of the relative risk for neonatal sepsis demonstrated that TBARS was a better predictor, being independently associated with neonatal sepsis.

CONCLUSION

Our findings demonstrated that cord blood IL-6, IL-10, and oxidative stress markers were significantly higher in infants with neonatal sepsis, and only TBARS levels were independently related to the development of neonatal sepsis in our sample.