Components of the systemic fetal inflammatory response syndrome as predictors of impaired neurologic outcomes in children.

Abstract

OBJECTIVE:

The purpose of this study was to compare interleukin-6 and funisitis as predictors of impaired neurologic outcomes in children by performing a secondary analysis on data that were collected prospectively for another purpose.

STUDY DESIGN:

We examined umbilical cords for funisitis and obtained cord blood for interleukin-6 levels. A psychomotor developmental index score was determined for each child at age 18 months.

RESULTS:

The prevalence (46%) of elevated interleukin-6 levels (> or = 10 pg/mL) among children with low psychomotor developmental index scores (<100) was not significantly different from that of children with normal scores (47%). Among children with funisitis (n = 21), the median psychomotor developmental index score was 94; for children without funisitis (n = 92), it was 99 (P <.02). When the data were regressed for confounding, funisitis remained significant (adjusted odds ratio, 1.3; 95% CI, 1.1-1.9). Furthermore, funisitis was a more specific predictor of low psychomotor developmental index scores (P <.001), although elevated interleukin-6 levels were more sensitive.

CONCLUSION:

When used for the prediction of impaired neurologic outcomes in children, funisitis has better specificity and thus a better positive predictive value than does interleukin-6.

• Authors: Robert Mittendorf, Anthony G Montag, William MacMillan, Susan Janeczek, Peter G Pryde, Richard E Besinger, John G Gianopoulos, Nancy Roizen
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 188 Issue 6 Pg. 1438-4; discussion 1444-6 (Jun 2003) ISSN: 0002-9378 [Print] United States
• PMID: 12824976 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Interleukin-6

Topics

• Adult
• Cerebral Palsy (congenital, etiology)
• Female
• Fetal Blood
• Fetal Diseases (immunology)
• Humans
• Infant
• Infant, Newborn
• Inflammation (complications, immunology)
• Interleukin-6 (blood, immunology)
• Male
• Predictive Value of Tests
• Pregnancy
• Randomized Controlled Trials as Topic
• Risk Factors
• Sensitivity and Specificity
• Umbilical Cord