The Role of IL-6 for Predicting Neonatal Sepsis: A Systematic Review and Meta-Analysis

Objective: neonatal sepsis (ns) is a common and life-threatening disorder in infants. previous studies showed that interleukin-6 (il-6) may be a valid non-invasive and rapid method for diagnosis of ns. we conducted this review to assess the validity of il-6 for predicting ns. methods: this was a systematic review with meta-analysis. embase, medline and web of science databases were searched between january 1990 and december 2009. the search terms used were cytokine, neonate, sepsis and interleukin-6. we used standard methods recommended for meta analyses of diagnostic test evaluations. the analysis was based on a summary roc (sroc) curve. meta-regression analysis was used to assess the effects of some confounding factors on the results of meta-analysis. potential presence of publication bias was tested using funnel plots and the egger test. findings: meta-analysis was performed on 13 publications including 353 infants with sepsis and 691 control infants. the pooled sensitivity and specificity of il-6 was 0.79 and 0.84, respectively. the maximum joint sensitivity and specificity (i.e., the q value) in sroc curve was 0.82 and the area under curve (auc) was 0.89 (95% ci: 0.84-0.94). meta-regression analysis showed that the diagnostic accuracy of il-6 was not affected by confounding variables. the evaluation of publication bias showed that the egger test was not significant (p=0.07). conclusion: il-6 seems to be a valid marker for predicting ns. it may be considered for early diagnosis of sepsis in neonatal care units.