Umbilical blood levels of IL-6 and TNF-α as predictors of the central nervous system damage and retinopathy in preterm infants

Abstract

Objective The aim was to identify the critical levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and vascular endothelial growth factor-A in umbilical cord blood that could be used as markers for predicting the central nervous system (CNS) damage and retinopathy of prematurity (ROP) in preterm infants. Study Design A total of 158 preterm infants, born at 22 to 34 weeks of gestation, were evaluated in the first week after birth and at 36 to 37 weeks of postconceptual age. Results A significant relationship between CNS changes and concentrations of IL-6 (p<0.001) and TNF-α (p<0.001) in umbilical cord blood at 22 to 34 weeks of gestation was determined. The concentration of IL-6 >13.0 pg/mL predicts significant CNS damages in 36 to 37-week infants (p¼0.013). ROP was diagnosed in 24.8% infants (n¼149). It was detected that the levels of TNF-α >116.4 pg/mL (p<0.001) and IL-6 >13.0 pg/mL (p<0.05) in umbilical cord blood could predict 2 to 3/3 to 4 stages of ROP. Conclusion Critical values of IL-6 and TNF-α in predicting grade III intraventricular hemorrhage in the early adaptation and in predicting marked CNS damages and severe ROP stages in the later adaptation of preterm infants were determined.