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Journal of the Korean Society of Neonatology 2004;11(1):29-34.
Published online May 1, 2004.
Significance of Cytokine Levels in Neonates with Severe Fetal Distress.
Won Joung Choi, Jong Uk Lee, Chun Soo Kim, Sang Lak Lee, Joon Sik Kim, Tae Chan Kwon
1Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea. lsl@dsrnc.or.kr
2Department of Pediatrics, Chunga General Hospital, Masan, Korea.
심한 태아 곤란증 신생아에서 생후 혈중 Cytokine 수치의 의의
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To determine the relation between the initial plasma cytokine response and the neurological prognosis in term infants with severe fetal distress. METHODS: Infants with severe fetal distress at birth (n=23) were studied prospectively. Cytokine concentrations were measured from umbilical cord blood at 3 and 12 hours of life by enzyme-linked immunosorbent assays for interleukin (IL)-1beta, IL-6, and IL-18. The study groups were divided into good (n=14) or poor prognostic group (n=9) according to survival and presence of cerebral palsy (CP) later and correlations with afore mentioned cytokine levels were determined. RESULTS: Cord blood IL-1beta and IL-18 concentrations were similar in both groups. However, infants with poor prognosis had significantly higher median (range) IL-6 concentration than infants with good prognosis at 3 hours [323.6 (32.6-812.8) vs. 38.4 (6.3- 322.7) pg/mL] (P=0.001), and 12 hours of life [287.1 (16.4-769.1) vs. 66.2 (8.8-757.8) pg/mL] (P<0.05). Significant higher IL-6 levels greater than 200 pg/mL were observed at 3 hours (P=0.005) and at 12 hours of life (P=0.023) for poor prognosis group.
There was a significant correlation between neurologic outcome and plasma IL-6 levels. Higher concentrations of IL-6 (>200 pg/mL) may be a useful indicator of poor neurological outcome in infants with severe fetal distress.
Key Words: Cytokine; Interleukin (IL-1beta, IL-6, IL-18); Fetal distress


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