الفهرس 
General virologyOnly 14 pages are availabe for public view
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Abstract
Intracranial hemorrhage is probably the most commonly
encountered accident to the brain in preterm infants. Some inflammatory
markers; namely interleukins, can be a useful tool to predict the later
development of intraventricular hemorrhage in preterm infants. The aims
of this prospective cross-sectional study were to assess the value of
measurement of umbilical cord blood interleukin-6 levels for prediction of
the occurrence of intraventricular hemorrhage in preterm infants. It was
carried out in the neonatal intensive care unit (NICU) of Hospital of
Alexandria University. All preterm babies <37 wk of gestation born from
July 2009 to April 2011 were included.
We excluded Preterm babies born to mothers with preterm premature
rupture of membranes or those with suspected or proved chorioamnionitis,
Preterm babies born to mothers who received antenatal steroids and Full
term babies (gestational age >37 weeks). All babies subjected to adequate
history taking and thorough clinical examination. Collection of umbilical
cord blood samples for measurement of interleukin-6 levels using
commercially available ELISA kits. Cranial ultrasound examination during
first week of life was done for all infants to diagnose IVH and repeated in
infants with IVH as indicated. A transfontalle approach was used and both
coronal and sagittal views were obtained.
Selected variables that could affect the incidence of IVH in the infants
were also studied including birth weight, gestational age, pregnancy induced
hypertension, intrauterine growth restriction, respiratory distress syndrome,
mechanical ventilation and patent ductus arteriosus.
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Ninety babies were studied; 42 males and 48 females. Their
gestational age range was (27-36wk) with the mean of (31.5±2.7). Thirty
patients developed IVH & those comprised the (IVH group). Sixty
patients didn′t develop IVH (non-IVH group).
The overall incidence of IVH was estimated as 33% (30/90) of cases.
Gender, mode of delivery, being SGA, having RDS, and even MV
were not independent risk factors for development of IVH.
One- and five-minute-Apgar score was comparable between IVH
and no-IVH groups; 5-minute Apgar (median 8 for both, p=0.24).
IVH neonates were significantly more immature compared to no-
IVH neonates (29.7±2.2 vs. 33.5±1.9, respectively; p<0.001). In addition,
IVH neonates were significantly smaller in size than no-IVH neonates
with BW (1178.5±246 vs. 1290±115, respectively; p=0.017).
Cord blood IL-6 levels, measured in pg/ml, were significantly higher
in IVH compared to no-IVH neonates (median of 525 vs. 10, respectively;
p<0.001); figure (12).
These levels correlated negatively with GA; figure (13), and BW [r=
-0.56 (p< 0.001) and -0.26 (p=0.014), respectively].
A cut-off value of 80 pg/mL of cord blood IL-6 for prediction of
IVH was calculated with a sensitivity of 96.77%, specificity of 100%,
positive predictive value (PPV) of 100%, and negative predictive value
(NPV) of 98.36%.
The importance of each variable in the study, as a predictor for IVH
development, was calculated independently; the highest percentage of
importance was that for cord blood IL-6 followed by gestational age