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Review
. 2018 Nov;97(47):e13146.
doi: 10.1097/MD.0000000000013146.

Interleukin-6 for early diagnosis of neonatal sepsis with premature rupture of the membranes: A meta-analysis

Xia Qiu  1 , Li Zhang  1 , Yu Tong  1   2 , Yi Qu  1   2 , Huiqing Wang  1   2 , Dezhi Mu  1   2
Affiliations
Review

Interleukin-6 for early diagnosis of neonatal sepsis with premature rupture of the membranes: A meta-analysis

Xia Qiu et al. Medicine (Baltimore). 2018 Nov.

Abstract

Background: Premature rupture of the membranes (PROM) is the principal risk factor for neonatal sepsis. Interleukin-6 (IL-6) has been investigated for early diagnosis of neonatal sepsis, but not for diagnosis of neonatal sepsis with PROM. The objective of this study is to investigate the early diagnostic value of IL-6 for neonatal sepsis with PROM.

Methods: The literature was searched using PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wan Fang, VIP, and CBM databases until March 2018. Each study was evaluated using Quality Assessment of Diagnostic Accuracy Studies tool-2. We used a bivariate diagnostic random-effects model.

Results: The overall pooled sensitivity, specificity, positive likelihood rate, negative likelihood rate, diagnostic odds ratio, and area under the summary receiver operating characteristic curve were 0.85 (95% confidence interval [CI]: 0.81-0.91), 0.88 (95% CI: 0.86-0.91), 9.94 (95% CI: 4.27-23.15), 0.14 (95% CI: 0.06-0.32), 79.26 (95% CI: 23.42-268.26), and 0.9473, respectively, which showed high accuracy in diagnosing neonatal sepsis with PROM. The types of sepsis might be connected with the source of heterogeneity (P = .0351).

Conclusion: IL-6 is therefore a sensitive and specific diagnostic marker for the early diagnosis of neonatal sepsis with PROM.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flowchart of the process of the identified and included articles.
Figure 2
Figure 2
Risk of bias and applicability concerns of included studies.
Figure 3
Figure 3
The forest plots of the pooled sensitivity of IL-6 to diagnose neonatal sepsis in PROM. CI = confidence interval, IL-6 = interleukin-6, PROM = premature rupture of the membranes.
Figure 4
Figure 4
The forest plots of the pooled specificity of IL-6 to diagnose neonatal sepsis in PROM. CI = confidence interval, IL-6 = interleukin-6, PROM = premature rupture of the membranes.
Figure 5
Figure 5
The summary receiver operating characteristic curve for assessment of IL-6 to diagnose neonatal sepsis in PROM. AUC = area under curve, SROC = summary receiver operating characteristic, IL-6 = interleukin-6, PROM = premature rupture of the membranes, SE = standard error.
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