Maternal Serum Interleukin-6 as a Biomarker for Early detection of Preterm Labor

Abstract

Marwa Badr, Sarah Adam, Ahmed Khairy Elnagar, Waleed Hitler and Khalil El-Lamei

Preterm labor, defined as the onset of labor before 37 weeks of gestation, remains a significant challenge in obstetrics. It is a leading cause of neonatal morbidity and mortality worldwide. Maternal serum interleukin-6 (IL- 6) has emerged as a promising biomarker that may aid in the early detection of preterm labor. This article explores the role of maternal serum IL-6 as a potential biomarker and its implications in the prediction of preterm labor.

Methods of Study: This is case-control study of preterm birth conducted at a tertiary care center at Ain Shams University. We enrolled 88 women with singleton pregnancies divided into two groups. Group 1 (study group), Included 44 women after 28 weeks and 0 days and before 37 weeks and 0 days of gestational age diagnosed with preterm labor. Group II (The control group), Included 44 women singleton pregnancies after 28 weeks and 0 days and before 37 weeks and 0 days of gestational age and not in labor who delivered at term. Maternal placental tissues and maternal serum interleukin-6 (IL-6) were evaluated for cases and control groups. The primary outcome is the recorded higher elevation of interleukin -6 in case group with evidences of infection in the placental tissue. Secondary Outcome, preterm delivery of those who showed higher levels of maternal serum interleukin -6.

Results: Among 88 studies women, levels were statistically significantly higher among case group of preterm labor compared to women who delivered at term (mean IL-6: 138.27 vs. 7.55 pg/mL, P < 0.0001). Similarly, levels were statistically significantly higher among women who infected placental tissues compared to the none infected placental tissue (mean IL-6: 175.33 vs. 27.08 pg/mL, P< 0.0001). There was no statistical difference between cases and control groups regarding the mean age, number of deliveries, early pregnancy losses.

Conclusions: After controlling the potential confounders, we recorded in this study a positive correlation between the higher levels of biomarker of InterleukinL-6 among women who presented in our tertiary center with preterm labor, suggesting an imbalance of immune regulation could impact cervical length and could be used as a marker of an early prediction of preterm labor. The interleukin-6 shows mild elevation in all non-infected preterm labors with 13.35 pg/ml as a cut-off point and shows also higher elevation in infected preterm labor with 50.5 pg/ml as cut-off point. Therefore, Maternal Serum Interleukin-6 can be used as a marker to predict the infection induced preterm labor.

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