Department of Obstetrics and Gynecology, National Hospital Organization, Saga National Hospital, Saga, Japan.
Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University, Saga, Japan.
J Obstet Gynaecol Res. 2023 Jun;49(6):1498-1505. doi: 10.1111/jog.15630. Epub 2023 Mar 4.
This study aimed to clarify the diagnostic accuracy of amniotic fluid interleukin-6 for fetal inflammatory response syndrome (FIRS).
This retrospective cohort study was conducted in a single institution and targeted cases of preterm birth within 24 h after amniocentesis among singleton cases that underwent amniocentesis at our hospital for suspected intraamniotic inflammation (IAI) from gestational ages of 22-36 weeks between August 2014 and March 2020. FIRS was defined as >11.0 pg/mL of umbilical cord blood interleukin-6.
The analysis included 158 pregnant women. There was a strong correlation between amniotic fluid interleukin-6 and umbilical cord blood interleukin-6 (r = 0.70, p < 0.001). The area under the receiver operating characteristic curve of amniotic fluid interleukin-6 for FIRS was 0.93, with a cutoff value of 15.5 ng/mL, and showed high sensitivity and specificity (0.91 and 0.88, respectively). An amniotic fluid interleukin-6 cutoff value of ≥15.5 ng/mL was associated with a significant risk of FIRS (adjusted odds ratio: 27.9; 95% confidence interval: 6.3-123.0; p < 0.001).
The results of this study show that amniotic interleukin 6 alone can be used to diagnose FIRS prenatally. While there is a need for validation, it may be possible to treat IAI while preventing damage to the central nervous and respiratory systems in the uterus by keeping the amniotic fluid interleukin-6 below the cutoff value.
本研究旨在明确羊水白细胞介素-6（IL-6）对胎儿炎症反应综合征（FIRS）的诊断准确性。
这是一项单中心回顾性队列研究，纳入了 2014 年 8 月至 2020 年 3 月在我院因疑似羊膜腔内感染（IAI）行羊膜腔穿刺术且穿刺后 24 小时内早产的单胎孕妇。FIRS 定义为脐血白细胞介素-6 ＞11.0 pg/ml。
共纳入 158 例孕妇，羊水白细胞介素-6 与脐血白细胞介素-6 呈强相关（r=0.70，p＜0.001）。羊水白细胞介素-6 预测 FIRS 的受试者工作特征曲线下面积为 0.93，截断值为 15.5ng/ml，具有较高的灵敏度和特异度（分别为 0.91 和 0.88）。羊水白细胞介素-6 截断值≥15.5ng/ml 与 FIRS 显著相关（调整优势比：27.9；95%置信区间：6.3-123.0；p＜0.001）。
本研究结果表明，单独使用羊水白细胞介素-6 即可产前诊断 FIRS。虽然需要进一步验证，但通过将羊水白细胞介素-6 控制在截断值以下，可能有希望在治疗 IAI 的同时预防子宫内中枢神经系统和呼吸系统损伤。
