OBJECTIVE: To evaluate umbilical cord blood interleukin (IL)-6 concentrations and the occurrence of fetal inflammatory response syndrome (FIRS) with respect to microbial invasion of the amniotic cavity (MIAC) and/or intraamniotic inflammation (IAI) in pregnancies complicated by preterm prelabor rupture of membranes (PPROM). METHODS: One-hundred-eighty-eight women with singleton pregnancies complicated by PPROM between gestational ages of 24 + 0 and 36 + 6 weeks were included in the study. Blood samples were obtained by venipuncture from the umbilical cord after the delivery of the newborn. The umbilical cord blood IL-6 concentrations were evaluated using ELISA kits. FIRS was defined as umbilical cord blood IL-6 > 11 pg/mL. RESULT: Women with MIAC and IAI had higher IL-6 concentrations than women without these complications (with MIAC: median 18.1 pg/mL versus without MIAC: median 5.8; p < 0.0001; with IAI: median 32.9 pg/mL, versus without IAI: median 5.8; p < 0.0001). Women with IAI with MIAC and women with IAI without MIAC had the highest umbilical cord blood IL-6 concentrations (medians: 32.6 and 39.4 pg/mL) and rates of FIRS (78% and 67%). CONCLUSIONS: IAI was associated with the highest umbilical cord blood IL-6 concentrations and rate of FIRS independent of the presence or absence of MIAC.

b Department of Clinical Immunology and Allergy Faculty of Medicine Charles University Prague Hradec Kralove University Hospital Hradec Kralove Hradec Kralove Czech Republic

c Department of Obstetrics and Gynecology Faculty of Medicine Ostrava University Ostrava Czech Republic

Department of Obstetrics and Gynecology Faculty of Medicine Charles University Prague Hradec Kralove University Hospital Hradec Kralove Hradec Kralove Czech Republic

Department of Obstetrics and Gynecology Sahlgrenska Academy Gothenburg University Gothenburg Sweden

e Department of Genetics and Bioinformatics Area of Health Data and Digitalisation Institute of Public Health Oslo Norway

f BCNatal Barcelona Center for Maternal Fetal and Neonatal Medicine Fetal I D Fetal Medicine Research Center IDIBAPS University of Barcelona Barcelona Spain

g Center for Biomedical Research on Rare Diseases Barcelona Spain and

h Biomedical Research Center University Hospital Hradec Kralove Hradec Kralove Czech Republic

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Late preterm prelabor rupture of fetal membranes: fetal inflammatory response and neonatal outcome

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