Original Article This work is licensed under the Creative Commons Attribution 4.0 License. Published by Pacifc Group of e-Journals (PaGe) Study of Interleukin-6 as an Indicator Biomarker in Perinatal Asphyxia Introduction Perinatal asphyxia is the lack of oxygen and/or blood supply to the developing brain that could end in permanent neurological damage due to hypoxic- ischemic encephalopathy (HIE), most of the events relating to intrapartum insults.[1] It is estimated that, in developed world 1/1000 live births, and 5-10/1000 live births in developing world suffer asphyxia perinatally. Approximately more than four million neonates are annually affected by severe perinatal asphyxia worldwide out of which around 20% die, and another 20% develop clinically signifcant sequelae.[2] In India, according to the National Neonatal-Perinatal Database 2002–03, asphyxia contributed to 29% of neonatal deaths.[3] The topography of injury correlates with areas of hypoxia and ischemia which results into anaerobic metabolism and generates high levels of lactate and inorganic phosphates. Toxic molecules and free radicals accumulate in the damaged tissue.[4] Hypoxic-ischemic brain injury after severe birth asphyxia remains a clinical problem despite improvements in obstetric and neonatal care.[5] Though several critical factors have been defned despite the complex pathophysiology of HIE, the elaborate mechanisms of brain injury and the signifcant mediators are largely unknown. [6-8] It is of utmost signifcance to increase the understanding of the events leading to brain injury and to identify early markers predicting outcome after birth asphyxia. To the best of our knowledge, there is paucity of studies that have evaluated the association between hypoxia- ischemia and release of cytokines among Indian neonates. Therefore, the purpose of the present study was to investigate if serum IL-6 concentrations could be used as an indicator marker of perinatal asphyxia in neonates. IL-6 is a commonly available parameter but cost could be a problem in a proportion of population. Cytokines modulate apoptosis of CNS cells. Though the exact role of IL-6 is unclear.[9] Other than CRP and Ferritin other acute phase reactant markers like procalcitonin are costlier. IL-6 estimation is helpful in differentiating the perinatal asphyxia babies from the healthy babies and the levels are signifcantly associated with severity of perinatal asphyxia Tajuddin Mohd 1 *, Iqbal R Kaur 2 , Bineeta Kashyap 2 , MMA Faridi 3 and NP Singh 2 1 Department of Microbiology, Delhi State Cancer Institute, Delhi, India 2 Department of Microbiology, UCMS & GTB Hospital, Delhi, India 3 Department of Pediatrics, UCMS & GTB Hospital, Delhi ABSTRACT Background: Birth asphyxia, though not always a recognizable cause, is a well documented contributor to perinatal and neonatal mortality. Four million babies are born asphyxiated annually resulting into 20% of all neonatal deaths. Perinatal asphyxia is the ffth largest cause of under-5 deaths Methods: Serum IL-6 levels were measured by ELISA in sera of thirty newborn babies ≥31 weeks of gestation with Apgar score <8 at 1 minute after birth with perinatal asphyxia (Study group) and 30 age and sex matched healthy controls (Control group), at birth (within 6 hours) and 48 hours after delivery. Result: The mean levels of IL-6 in the study and control groups were 158.09±63.76 pg/ml and 41.57±71.23 pg/ml at birth and 187.96±30.31 pg/ml and 24.54±58.74 pg/ml at 48 hours respectively. Rise in levels of IL-6 in study group when compared with the control was statistically signifcant both at birth and at 48 hours. The median IL-6 levels in the study group and control group were 196.40 pg/ml and 4.17 pg/ml respectively at birth. The median IL-6 levels in the study group at birth were 47 fold higher than levels of control group. Median IL-6 levels both at birth and at 48 hours were statistically not signifcant among the mild, moderate and severely asphyxiated neonates. Amongst 30 healthy neonates, IL-6 levels were statistically not signifcant both at birth and at 48 hours. Conclusion: IL-6 levels were signifcantly raised at birth and after 48 hours in asphyxiated neonates compared to gestational age and sex matched healthy neonates. Keywords: IL-6; Neonates; Perinatal; Asphyxia; 48 Hours DOI: 10.21276/APALM.2275