| as both cause and effect. It not only leads to perinatal infection in puerpera, but also easily increases the incidence of infectious diseases in the early stage of newborns,especially most harmful in early onset neonatal sepsis(EONS). EONS refers to onset of neonatal sepsis within 7 days. Bacteria and fungus invade into patient's blood circulation for growth and reproduction thereby producing toxins and resulting in systemic infection. The early symptoms are not easily found without specificity.However, due to newborns have low immunity and the disease tends to be fast progressed, the fatality rate is high with a lot of sequelae. Currently, the present time of common indexes used for diagnosis of sepsis clinically, such as blood culture,white blood count(WBC) and I/T ratio, may be too late following an infection with a lower positive rate, so they are not fit for early diagnosis and may delay the treatment,resulting in bad consequences. Therefore, it is important to find out an early, fast and reliable method to diagnose EONS.Background Premature rupture of membrane(PROM) and chorioamnionitis interactObjective To study the level change of IL-6?CRP in cord blood of newborns with PROM combined chorioamnionitis, and analyze the diagnosis value of these two inflammatory mediators for EONS.Methods A total of 187 full term newborns with PROM>12h under transvaginal eutocia in Fujian Maternity and Children Hospital between April 1, 2015 and December 31, 2015 were selected as the case group while 50 cases of simultaneously natal full term healthy newborns by non-PROM healthy puerpera were enrolled in the control group. Puerpera has no systemic infection sign except uterine cavity in case group. Umbilical blood was drawn immediately after a newborn being delivered in both group. The placenta was sent for testing and newborn prognosis is followed up in case group. Newborns in the case group were divided into chorioamnionitis group and non-chorioamnionitis group based on whether chorioamnionitis happen; and EONS group and non-EONS group based on whether newborns suffered from EONS.Therefore,the fluctuant levels of IL-6 and CRP were compared respectively with those in the groups as we have mentioned above. Receiver operating characteristics(ROC) curves were drawn to find out the cut-off points of serum IL-6 ? CRP in diagnosis EONS.Results 1 IL-6 and CRP in newborn's cord blood in the case group were higher than those of control group. The difference had statistical significance(p<0.05).2 The incidence of EONS of chorioamnionitis group was significantly higher than that of non-chorioamnionitis group(p<0.05).3 The level of IL-6 and CRP in the chorioamnionitis group was significantly higher than that in the non-chorioamnionitis group?control group(All p<0.05). The level of IL-6 in the non-chorioamnionitis group was significantly higher than that in control group(p<0.05), but there was not significant difference on CRP between the non-chorioamnionitis group and control group(p>0.05).4 The level of IL-6 and CRP in the EONS group was significantly higher than that in the non-EONS group ? control group(All p<0.05). The level of IL-6 and CRP in the non-EONS group was significantly higher than that in control group(p<0.05).5 Depended on the level of cord blood IL-6 and CRP in the EONS group and non-EONS group, ROC curve was drawn. The cut-off points that used to diagnose the EONS were62.62 pg/ml?1155.0 ng/ml, respectively, in cord blood IL-6 and CRP. The sensitivity,specificity, positive predictive value and negative predictive value as followings: IL-6:76.2%?91.0%?51.6%?96.8%, CRP: 61.9%?88.6%?40.6%?94.8% and joint test: 85.7%?84.3%?40.9%?97.9%.Conclusions The level of IL-6 ? CRP in cord blood of newborns with PROM combined chorioamnionitis were higher. PROM combined chorioamnionitis may increase the risk of EONS in newborns. Cord blood IL-6 and CRP have clinical value in early diagnose the EONS, and joint test could improve the sensitivity of EONS diagnosis. |
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