Cord blood TNF-α and IL-6 levels as diagnostic indicators of brain damage in neonates with non-asphyxia fetal distress.

PURPOSE: We investigated prospectively cord blood TNF-α and IL-6 levels as diagnostic indicators of brain damage in neonates with non-asphyxia fetal distress.

METHODS

Eighty neonates delivered by cesarean section from January 2013 to December 2014 were enrolled. Magnetic resonance imaging was conducted to determine brain damage. Neonates were assigned to a healthy control group (n = 30) or, with fetal distress, apportioned to groups with or without brain damage (n = 20 and 30, respectively). After delivery, the umbilical arterial blood of all neonates was harvested. Serum tumor necrosis factor-alpha (TNF-α) and interleukin 6 (IL-6) levels were evaluated to investigate a correlation between cord blood TNF-α and IL-6 levels and brain damage caused by non-asphyxia fetal distress.

RESULTS

The TNF-α and IL-6 levels in the cord blood of brain-damaged neonates with fetal distress (75.63 ± 7.68 and 217.95 ± 25.15 pg/mL, respectively) were significantly higher than that of neonates with fetal distress without brain damage (43.67 ± 5.54, 119.08 ± 12.30 pg/mL) or the healthy neonates (42.35 ± 6.63, 128.46 ± 16.15 pg/mL); the latter two groups were comparable for both TNF-α and IL-6. The receiver operating characteristic curve showed that when TNF-α (IL-6) reached 53.23 pg/mL (156.23 pg/mL), the specificity and sensitivity for diagnosis of brain damage was 80.3% (82.5%) and 90.1% (81.5%), respectively.

CONCLUSION

Monitoring TNF-α and IL-6 levels in umbilical cord blood may assist early diagnosis of brain damage in neonates with non-asphyxia fetal distress.