Gedikbaşi A, Salihoğlu Ö, Çankaya A, Arica V, Akkuş Ch, Hatipoğlu S, Yaşar L
Department of Biochemistry, Bakirköy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
Department of Pediatric Clinic, Bakirköy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
Hum Exp Toxicol. 2014 Dec;33(12):1193-8. doi: 10.1177/0960327113499049. Epub 2014 Feb 17.
The aim of this prospective study was to establish the cord blood interleukin 1β (IL-1β) levels and asphyxia enzymes in term newborns and their relationship between delivery modes. We investigated whether cord blood level of IL-1β could be used as a reliable marker for detecting hypoxic stress and to determine the optimal cut-off level for IL-1β.
The study was designed prospectively. Cord blood samples were obtained at the time of delivery from 75 noninfected full-term neonates for the purpose of measuring cord blood levels of IL-1β. Women were classified into three groups according to the mode of delivery (20 vaginal delivery, 29 urgent caesarean section (with foetal distress) and 26 elective caesarean section). All cases were followed-up by hospitalization. Umbilical cord sampling was carried out for IL-1β, umbilical artery gas parameters and other asphyxia enzymes at the time of delivery. Cord blood IL-1β was measured by enzyme-linked immunosorbent assay. The perinatal outcomes of the cases were recorded after birth. Demographic characteristics, neonatal outcomes and laboratory findings were compared in all the three groups.
IL-1β levels showed statistically significant difference between groups (p < 0.01). The relationship was found between IL-1β cord blood levels and the mode of delivery. IL-1β levels of urgent caesarean section group were significantly higher than elective caesarean section and normal delivery group (p:0.001 and p:0.001, respectively). Normal delivery levels were significantly higher than the elective caesarean group (p:0.001).
Urgent section (foetal distress) and vaginal delivery (labour) were each associated with elevated IL-1β cord blood levels in noninfected full-term neonates, while only elective caesarean section was associated with decreased IL-1β levels. For the evaluation of newborns at high risk for perinatal hypoxic stress, cord blood IL-1β levels may lead the way. On the other hand, the mode of delivery may be associated with the effects on the immune system. Further investigations with larger patient groups are required to confirm our results.
本前瞻性研究旨在确定足月儿脐带血白细胞介素1β（IL-1β）水平及窒息相关酶水平，并探讨其与分娩方式之间的关系。我们研究了脐带血IL-1β水平是否可作为检测缺氧应激的可靠标志物，并确定IL-1β的最佳临界值。
本研究为前瞻性设计。在分娩时从75例未感染的足月儿获取脐带血样本，以测定脐带血IL-1β水平。根据分娩方式将产妇分为三组（20例阴道分娩、29例急诊剖宫产（伴有胎儿窘迫）和26例择期剖宫产）。所有病例均住院随访。在分娩时采集脐带血样本检测IL-1β、脐动脉血气参数及其他窒息相关酶。采用酶联免疫吸附测定法检测脐带血IL-1β。记录出生后病例的围产期结局。比较三组的人口统计学特征、新生儿结局及实验室检查结果。
各组间IL-1β水平差异有统计学意义（p < 0.01）。发现脐带血IL-1β水平与分娩方式有关。急诊剖宫产组的IL-1β水平显著高于择期剖宫产组和正常分娩组（分别为p:0.001和p:0.001）。正常分娩组的IL-1β水平显著高于择期剖宫产组（p:0.001）。
急诊剖宫产（胎儿窘迫）和阴道分娩（产程）均与未感染足月儿脐带血IL-1β水平升高有关，而只有择期剖宫产与IL-1β水平降低有关。对于评估有围产期缺氧应激高危风险的新生儿，脐带血IL-1β水平可能具有指导作用。另一方面，分娩方式可能与对免疫系统的影响有关。需要更大样本量的患者群体进行进一步研究以证实我们的结果。
