A80
RISK OF NEONATAL INFECTION AFTER PREMATURE RUPTURE OF FETAL MEMBRANES
Stiemer B, Buschmann A, Hensel K, Weitzel HK
Department of Obstetrics and Gynaecology, Universitaetsklinikum Benjamin Franklin, Freie Universitaet
Berlin, Hindenburgdamm 30, 12200 Berlin, Germany
Intra-amniotic infection after premature rupture of fetal membranes (PROM) is still an unresolved problem.
Indicators of fetal infection in utero are few and management is difficult. A number of cytokines e.g.
interleukin-6 and interleukin-8 (IL-8) are involved in inflammatory processes. Their
usefulness as indicators for intra-uterine infections has to be further investigated.
Aim: With this study we attempted to identify A) factors associated with an increase in the frequency of
neonatal infection and B) to evaluate whether IL-8 in urine could be used as an indicator of fetal infection in
utero after PROM.
Methods: Eighty-seven newborns (singleton deliveries) and placentas from women with PROM between 25
and 40 weeks of gestation were examined. Midstream urine was collected of the mothers from admission after
PROM to delivery. IL-8 was measured in these urines by ELISA (mono- and polyclonal antibodies against
human recombinant IL-8) and by the IMMULITE System (automated chemiluminescent immunoassay system,
DPC Biermann GmbH, Bad Nauheim, Germany). Non-parametric tests were undertaken for statistical analysis
(Mann Whitney-U, Wilcoxon Rank Sum, Kruskal-Wallis).
Results: A) Severe chorioamnionitis had a relative risk of 4.6 for the development of neonatal infection (NI).
The risk factor of a delivery before 32 weeks gestation was 3.7 for NI. An interval of more than 24 hours
between PROM and delivery increases the risk for NI by a factor of 2.1. B) IL-8 measurements showed
significantly elevated values (p<0.001) in cases of chorioamnionitis, delivery before 32 weeks gestation and
neonatal infection (medians of 404ng/l, 174ng/l and 330ng/l compared to a median of 34ng/l without infection).
Conclusion: These results could help to identify the neonates at risk to develop NI after PROM by detection of
severe chorioamnionitis, by early gestational week, by increased PROM-delivery-interval >24 hours and by
elevated IL-8 values in maternal urine.