Umbilical Blood Levels Of Il-6 And Tnf-Alpha As Predictors Of The Central Nervous System Damage And Retinopathy In Preterm Infants

Objective The aim was to identify the critical levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), 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- ( 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 ( p =0.013). ROP was diagnosed in 24.8% infants ( n =149). It was detected that the levels of TNF-alpha >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- 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.