Umbilical cord blood level of interleukins used as a predictor of earlyonset neonatal sepsis: a comprehensive review

Maria-Andreea Răcean ¹ Maria Oana Sasaran ^2* Cristina Oana Marginean ³ Manuela Cucerea ¹

• ¹ Department of Pediatrics 4, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” from Târgu Mureș, Romania, Targu Mures, Romania
• ² Department of Pediatrics 3, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Târgu Mureș, Targu Mures, Romania
• ³ Department of Pediatrics 1, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” from Târgu Mureș, Romania, Targu Mures, Romania

Neonatal sepsis (NS) is a major cause of morbidity and mortality in both preterm and term infants; early-onset NS (EONS) occurs in newborns within the first 72 hours of life. Cytokines are messengers with low molecular weight that are produced by macrophages and lymphocytes in response to antigenic stimulations or products of inflammation. Different interleukins (IL) have higher values in EONS, when detected from peripheral venous blood. This review aims to analyze if the cytokines determined from the umbilical cord blood (UCB) of newborns may help in the rapid and accurate diagnosis of EONS, in newborns originating from pregnancies with maternal-fetal infectious risk. Three databases, namely Pubmed, Scopus and Web of Science, were searched for original research articles which assessed the relationship between interleukins and EONS. The search results retrieved a number of 18 articles which complied to the inclusion and exclusion criteria. Some studies report that neonates with EONS had higher umbilical plasma levels of cytokines such as IL-1ß, IL-6, IL-8, IL-10, IL-18 and IL-27. However, results are controversial, as many authors failed to establish the cut-off values of cytokines detected from UCB that may predict EONS. The main limitations of current studies remain the small study samples, the heterogeneous population and the lack of stratification of the studied population according to gestational age (GA). The cytokines that seem to be more accurate in early diagnosis of EONS, as reported by the majority of the studies, are IL-6 and IL-8. The level of these cytokines may guide clinicians in the careful administration of antibiotics, thus aiding in the overall reduction of antimicrobial resistance.