Diagnostic Utility of Interleukin-6 in Early-Onset Sepsis among Term Newborns: Impact of Maternal Risk Factors and CRP Evaluation

Author:

Schleier Maria1,Lubig Julia1,Kehl Sven2,Hébert Steven1,Woelfle Joachim1ORCID,van der Donk Adriana1,Bär Alisa1,Reutter Heiko13ORCID,Hepp Tobias4,Morhart Patrick1ORCID

Affiliation:

1. Department of Pediatrics and Adolescent Medicine, Division of Neonatology and Pediatric Intensive Care, Friedrich-Alexander-University of Erlangen-Nürnberg, Loschgestraße 15, 91054 Erlangen, Germany

2. Department of Gynecology and Obstetrics Medicine, Division of Obstetrics, Friedrich-Alexander-University of Erlangen-Nürnberg, Universitätsstraße 21/23, 91054 Erlangen, Germany

3. Institute of Human Genetics, Friedrich-Alexander-University of Erlangen-Nürnberg, 91054 Erlangen, Germany

4. Institute for Medical Informatics, Biometry and Epidemiology (IMBE), Friedrich-Alexander-University Erlangen-Nürnberg, Waldstraße 6, 91054 Erlangen, Germany

Abstract

(1) Background: Interleukin-6 (IL-6) levels act as an early infection marker preceding C-reactive protein (CRP) elevation. This study seeks to analyze IL-6 behavior in suspected early-onset sepsis (EOS) cases among term newborns, comparing it to that of CRP and evaluating IL-6’s diagnostic utility. We also aim to assess the impact of maternal risk factors on EOS in term newborns, quantifying their influence for informed decision making. (2) Methods: The retrospective data analysis included 533 term newborns who were admitted to our hospital because of suspected EOS. IL-6, CRP, and the impact of maternal risk factors were analyzed in the context of EOS using binomial test, Chi-squared test, logistic and linear regression. (3) Results: In the cases of EOS, both IL-6 and CRP were elevated. The increase in CRP can be predicted by the initial increase in IL-6 levels. Among the assessed risk factors, intrapartum maternal fever (adjusted odds ratio 18.1; 95% CI (1.7–4.1)) was identified as the only risk factor significantly associated with EOS. (4) Conclusions: Employing IL-6 as an early infection marker enhanced EOS diagnostic precision due to its detectable early rise. However, caution is required, as elevations in IL-6 and CRP levels do not exclusively indicate EOS. Increased CRP levels in healthy newborns with maternal risk factors may be attributed to dynamics of vaginal labor.

Funder

Deutsche Forschungsgemeinschaft

Friedrich–Alexander-Universität Erlangen-Nürnberg

Open Access Publication Funding

Publisher

MDPI AG

Subject

Pediatrics, Perinatology and Child Health

Reference47 articles.

1. AWMF (2023, August 21). Bakterielle Infektionen bei Neugeborenen. Available online: https://register.awmf.org/assets/guidelines/024-008l_S2k_Bakterielle_Infektionen_Neugeborene_2021-03.pdf.

2. Defining neonatal sepsis;Wynn;Curr. Opin. Pediatr.,2016

3. The burden of invasive early-onset neonatal sepsis in the United States, 2005–2008;Weston;Pediatr. Infect. Dis. J.,2011

4. Inflammatory markers in cord blood or maternal serum for early detection of neonatal sepsis-a systemic review and meta-analysis;Su;J. Perinatol.,2014

5. Interleukin-6 as a Biomarker of Early-Onset Neonatal Sepsis;Cortes;Am. J. Perinatol.,2021

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