Assessment of Cervical IL-6 Levels and Neonatal Inflammatory Response in Preterm Birth Following Preterm Premature Rupture of Membranes

Abstract

Background: Preterm premature rupture of membranes (PPROM) is a leading cause of preterm delivery, occurring in 40–50% of cases, with a 3–4% overall incidence. During expectant management, chorioamnionitis is typically monitored using serum inflammatory markers (e.g., leukocyte count, CRP), though cervical interleukin-6 (IL-6) has emerged as a promising local marker. This study investigated the correlation between cervical IL-6 and maternal and neonatal inflammatory parameters. Methods: This prospective non-randomized clinical trial was performed with 51 patients with expectantly managed PPROM. Samples were obtained twice a week using cervical swabs placed into a stabilizer solution. Cervical IL-6 levels were measured by routine automated chemiluminescence immunoassay, with reference to albumin levels. Maternal serum C-reactive protein (CRP) levels and leukocyte counts and neonatal serum CRP and procalcitonin (PCT) levels were also determined. Spearman correlations of the IL-6 level with other markers and clinicopathological parameters were examined. Results: Cervical IL-6 levels correlated more strongly with neonatal CRP and PCT levels on the first day after delivery than with maternal serum markers while showing no significant association with the PPROM-to-delivery interval. Conclusion: Cervical IL-6 level determination may help to inform the timing of labor induction in cases of PPROM, with consideration of the maternal and neonatal conditions. We believe that the monitoring of the cervical IL-6 level could enable good prediction of perinatal inflammation, although more data are needed to support this hypothesis.