The Relationship between Maternal Leukocyte Levels and Serum Interleukin-6 (IL-6) Levels and Duration of Premature Rupture of Membranes in Pregnant Women

Abstract

Introduction: Preterm premature rupture of membranes increases the risk of maternal and perinatal morbidity through an inflammatory response characterized by elevated maternal leukocyte counts and IL-6 levels as the duration of membrane rupture increases.

Objective: To analyze the relationship between maternal leukocyte count and serum IL-6 levels with the duration of rupture of membranes in pregnant women.

Methods: A cross-sectional study of 80 term pregnant women with PPL at Dr. Wahidin Sudirohusodo General Hospital and the University of Hasanuddin Faculty of Medicine network, dividing subjects based on the interval of membrane rupture (<8 to ≥24 hours), with leukocyte (hematology analyzer) and IL-6 (ELISA) testing, as well as analysis using the Kruskal–Wallis test and multinomial logistic regression.

Results: There were significant differences in leukocyte and IL-6 levels between the amniotic fluid rupture interval groups (p < 0.05). The proportion of leukocytosis increased gradually from 0% (<8 hours), 10% (8–12 hours), 85% (12–24 hours), to 100% (≥24 hours). The prevalence of elevated IL-6 levels also increased from 5% (<8 hours), 70% (8–12 hours), 90% (12–24 hours), to 100% (≥24 hours). Regression analysis showed that leukocyte levels (OR = 0.295) and IL-6 levels (OR = 0.832) differed significantly, particularly in the 12–24-hour interval compared to ≥24 hours, indicating a pattern of increasing inflammation corresponding to the duration of membrane rupture.

Conclusion: Maternal leukocyte and IL-6 levels are significantly associated with the duration of preterm rupture of membranes. IL-6 increases earlier than leukocytes, thus better reflecting early-phase intrauterine inflammation, whereas leukocytes better reflect systemic inflammation in the later phase. The combination of both provides a more comprehensive picture of the progression of inflammation in preterm rupture of membranes.