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G445(P) Diagnosis of an infectious process in newborns born by mothers with chronic inflammatory gynaecological diseases
  1. LL Kravchenko1,
  2. MA Levkovich1,
  3. Krukier II2,
  4. MV Pyatikova1,
  5. LM Zaurova1,
  6. AA Afonin1
  1. 1Pediatric Department, Rostov Scientific-Research Institute of Obstetrics and Pediatrics, Rostov-on-Don, Russia
  2. 2Department of Biomedical Problems, Rostov Scientific-Research Institute of Obstetrics and Pediatrics, Rostov-on-Don, Russia

Abstract

Aims To study indices of the cytokine state in umbilical blood of newborns born by women with chronic inflammatory gynaecological diseases in case of a late manifestation of the infectious process.

Methods 37 newborns born by women with chronic inflammatory gynaecological diseases were examined. The levels of interleukin-2 (IL-2), tumour necrosis factor (TNF-α), interferon gamma (IFN-γ) in umbilical blood were analysed using a kit for the enzyme-linked immunosorbent assay ProConIL-2, IFNgamma, TNF-α (“Protein Contour” Limited Liability Company, St. Petersburg).

The following software packages were used: Statistica version 6.0 and EXCEL 2003, SPSS 13.0, MegaStat. PolyAnalist 3.5 Pro package was used for the analysis of multidimensional nonlinear dependences.

Results Manifestations of the infectious process were not observed in all newborns within the first month of their life. From the end of the first month and up to the third month of life, clinical presentations of the infection, including viral infection, were observed in 15 newborns, cytomegalovirus DNA was detected in urine analyses that allowed diagnosing cytomegalovirus infection. In 22 newborns no clinical presentations of the infection were recorded. The control group was comprised of 15 newborns without infection.

Analysis of multidimensional nonlinear dependences using “PolyAnalist 3.5. Pro” package has shown factors which are significant for prognosis of the infectious process in the postnatal period: IL-2, TNF-α, IFN-γ. Formula of dependence of the infectious process prognosis on the content of IL-2, TNF-α, IFN-γ in umbilical blood of newborns born by mothers with chronic inflammatory gynaecological diseases in case of a late detection of cytomegalovirus DNA was suggested: IL-2* TNF-α <–527.79 + 4.1342* IFN-γ * TNF-α.

If this inequality is fulfilled, we prognosticate an infectious process in the postnatal period. Accuracy is 85%. If this inequality is not fulfilled, the infection will not develop. Accuracy is 91%. P < 0,000001. Sensitivity is 87%, specificity is 91%. Positive predictive value is 9.6; negative predictive value is 7.

Conclusions The formula is an early marker of the infectious process manifestation in newborns born by mothers with chronic inflammatory gynaecological diseases and it allows separating children of the risk group for the appropriate therapy prescription.

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