Relationship Between Early-onset Neonatal Sepsis And Levels Of IL-6,TNF-?,MMP-8 In The Amniotic Fluid Of Women With Premature Rupture Of Membranes

Objective: To explore the relationship between Early-Onset Neonatal Sepsis(ENOS) and levels of interleukin-6(IL-6), tumor necrosis factor-?(TNF-?) and Matrix Metalloprotein-8(MMP-8) in the amniotic fluid of women with premature rupture of membranes.Methods: The experimental groups chose 159 cases of full-term delivery infants born in Fujian Woman-Children Health Care Hospital from April 2015 to December 2015,meet the diagnosis of premature rupture of membranes(n=159).It requires that PROM time is longer than 12 hours.Chose 30 cases in the normal full-term cesarean infants who born in the same period as controls(n=30).The experimental groups divided into early-onset neonatal sepsis(EONS) group(n=25) and non-early-onset neonatal sepsis(non-EONS) group(n=134) according to Neonatal outcomes. And then the experimental groups were divided into chorioamnionitis(CAM) group(n=45) and non-chorioamnionitis( non-CAM) group(n=114) according to pathological examination of fetal membrane. The related cytokines in amniotic fluid were detected; the clinical data about the patient was followed up; the correlation between the levels of related cytokines and EONS was analyzed.Results: 1. There were statistically significant difference in the incidence rates of chorioamnionitis and amniotic fluid index(AFI) <5 between ENOS group and non- ENOS group(P<0.05); The incidence rate of chorioamnionitis in ENOS group was statistically significantly higher than that in non-ENOS group(P<0.05). 2.The levels of IL-6, TNF-?, MMP-8 in amniotic fluid of EONS group were statistically significantly higher than those in non- EONS group and control group(P<0.05). The levels of IL-6, TNF-?, MMP-8 in amniotic fluid of non- EONS group were statistically significantly higher than those in control group(P<0.05). 3.(1)The ROC curves showed that the area under curve of IL-6,TNF-?,MMP-8 were 0.824, 0.786 and 0.725?The area under curve of combined detection of the three markers was 0.855.(2)The sensitivity, specificity, positive predictive value, and negative predictive value of an IL-6 level(611.98pg/ml) were 56%, 93.9%, 56%, and93.2% for EONS?The sensitivity, specificity, positive predictive value, and negative predictive value of an TNF-? level(390.46pg/ml) were 64%, 83.5%, 37%, and93.8% for EONS?The sensitivity, specificity, positive predictive value, and negative predictive value of an MMP-8 level(411.99ng/ml) were 48%, 90.9%, 44.4%, and92% for EONS?The sensitivity, specificity, positive predictive value, and negative predictive value of combined detection of the three markers were 75%, 75%, 56%, 30.2%and95.2% for EONS? 4. The incidence rate of EONS in chorioamnionitis group was statistically significantly higher than that in non-chorioamnionitis group(P<0.05). 5.(1)The levels of IL-6, TNF-?, MMP-8 in amniotic fluid of chorioamnionitis group were statistically significantly higher than those in non-chorioamnionitis group(P<0.05).(2)In the chorioamnionitis group, the levels of IL-6, TNF-? in amniotic fluid of EONS occurred were statistically significantly higher than those in EONS(P<0.05), but the levels of MMP-8 in amniotic fluid of EONS were not statistically difference than those in non-ENOS occurred(P<0.05).Conclusion: 1. Women with Premature Rupture of Membranes and chorioamnionitis is closely related to Early-Onset Neonatal Sepsis. 2. Detecting the levels of IL-6, TNF-?, MMP-8 in amniotic fluid has active clinical significance for early detection, early intervention of ENOS, and combined detection of the three markers can improve the prediction efficiency.