SELENIUM AND VITAMIN E IN CORD BLOOD FROM PRETERM AND FULL TERM INFANTS

ABSTRACT. Selenium was determined in erythrocytes and serum, and vitamin E and β-lipoprotein in serum from cord blood samples of 31 full term and 20 preterm infants. Venous samples from 21 mothers at birth and 15 normal adult women were also analyzed. No difference for either selenium or vitamin E was found between the preterm and full term infants. The selenium concentration in red blood cells was the same for newborn, mothers at birth, and normal adult women. The serum concentration of selenium was, however, significantly lower in the newborn, the mean level in the children being 64% of that in the mothers. The level in the mothers did not differ from that in non-pregnant women. The vitamin E concentration was found to correlate very well with the β-lipoprotein concentration. This indicates that differences in the transport capacity account for the large difference in the serum tocopherol levels of mothers at birth and newborn.     

早产儿和足月儿脐血及母亲静脉血硒含量的比较

目的：硒是一种人体必需的微量元素,在细胞抗氧化防御系统中发挥着主要的作用。在早期早产儿中,低水平的硒会增加诸如慢性新生儿肺疾病、早产儿视网膜病等并发症的发生。该研究旨在检测并比较早产儿和足月儿脐血及母亲静脉血硒含量。方法：选取2008年3~7月间30个足月儿（胎龄>37 周）和30个早产儿（胎龄< 34 周）及他们的母亲作为研究对象。用原子吸收光谱法测定脐血和母亲静脉血的硒含量。结果：足月儿的脐血硒平均含量高于早产儿,差异有非常显著性(124.80± 13.72 μg/L vs 100.30 ± 11.72 μg/L, P=0.0001) 。 足月儿母亲与早产儿母亲的的平均硒含量差异无显著性 (117.03±17.15 μg/L vs 110.56±17.49 μg/L, P=0.15)。将所有婴儿的资料一起分析时,发现脐血硒含量与胎龄和出生体重显著正相关(r=0.66, P<0.0001;r=0.59, P<0.0001)。60例婴儿母亲中,无一例的血硒含量低于正常参考值的下限（70.0 μg/L）。将所有婴儿及其母亲的资料一起分析时,发现母亲血硒含量与其婴儿脐血硒含量呈显著正相关 (r=0.40, P<0.001)。结论：在伊斯法罕地区,孕母的血硒水平处于一个良好的状态,血硒水平不是早产的预测指标。足月儿的脐血硒含量高于早产儿,但足月儿和早产儿的脐血硒含量均在正常参考范围。［中国当代儿科杂志,2009,11（7）：513-516］     

Comparison between preterm and full term neonatal cord selenium in correlation to maternal serum selenium levels

Background

Lower concentrations of selenium and glutathione peroxidase activities have been reported in pregnant women. An exposure to a high oxygen concentration at birth, an infection, inflammation, and a deficient antioxidant system make the newborn more susceptible to oxidative stress that can result in bronchopulmonary dysplasia, retinopathy of prematurity, persistent ductus arteriosus, necrotizing enterocolitis, intracranial hemorrhage, and hypoxic ischemic encephalopathy, especially in extremely low-birth-weight infants.

Relationship of maternal and newborn (cord) serum ferritin concentrations measured by immunoradiometry

Serum ferritin concentration was determined by immunoradiometry in venous blood samples of 45 pregnant women at term, in their babies' cord blood samples, and blood specimens obtained from 43 infants aged 3-12 months. The concentration of ferritin was higher in cord serum than in respective maternal samples and infant specimens. Low values were found in more than half of the maternal venous samples. Iron stores of newborns delivered by mothers with low serum ferritin concentration were lower than in newborns of mothers having normal ferritin levels. Serum ferritin measurement is a sensitive method to determine iron deficiency in pregnancy.     

Antioxidant defense systems in newborns undergoing phototherapy

This paper was designed to investigate whether phototherapy is an oxidative stress in newborn infants undergoing phototherapy. A day-light continuous phototherapy was given to jaundiced 20 term and 16 preterm newborns for 72 hours. We measured serum vitamin E and the activities of red blood cell anti-oxidation enzymes (superoxide dismutase, catalase and glutathione peroxidase) before and after 72 h of phototherapy. Serum vitamin E levels were not different before and after 72 h of phototherapy in both preterm and term infants. In several studies, antioxidant enzyme activities have been shown to increase in response to oxidative stresses. In this study, however, the antioxidant enzyme activities in the hemolysate were similar before and at the end of the phototherapy in both preterm and full term. In conclusion, the results of ourin vivo study do not confirm the thesis that phototherapy is an oxidative stress in newborn infants. Therefore, phototherapy would preferably seem to be safe and efficient method of treatment for all neonates presenting with hyperbilirubinemia.     

早产儿出生时维生素D水平及影响因素分析

目的分析早产儿出生时维生素D水平及其可能影响因素。方法采集600例早产儿出生24 h内静脉血,检测血清25-羟基维生素D[25(OH)D]水平,并分析早产儿性别、出生体重、出生季节、胎龄,以及母亲的年龄、职业、早孕期体重指数(BMI)、分娩方式及妊娠期并发症等对血清25(OH)D水平的影响。结果早产儿维生素D缺乏、不足、充足的比例分别为42.0%、38.7%和19.3%。夏、秋季出生的早产儿血清25(OH)D水平显著高于冬季(P0.05),维生素D缺乏的发生率显著低于春、冬季(P0.003)。与母亲年龄≥30岁者比较,年龄30岁母亲所生早产儿血清25(OH)D水平显著降低(P0.05),维生素D缺乏的发生率显著增高(P0.017)。与母亲肥胖者比较,超重或体重正常母亲所生早产儿血清25(OH)D水平显著增高(P0.05),维生素D缺乏的发生率显著降低(P0.006)。母亲妊娠合并子癎前期者,其早产儿血清25(OH)D水平显著低于无子癎前期者(P0.05),维生素D缺乏的发生率显著高于无子癎前期者(P0.017)。多因素分析结果显示,冬春季出生、母亲年龄30岁及早孕期BMI≥28 kg/m2为早产儿维生素D缺乏的危险因素(P0.05)。结论早产儿维生素D缺乏发生率较高,有维生素D缺乏高危因素的早产儿生后需尽早补充维生素D。     

High prevalence of moderately severe vitamin D deficiency in preterm infants

Background: The recommended dose of vitamin D supplementation of preterm infants is based on data from populations in which severe vitamin D deficiency is uncommon and may be inadequate for infants in high risk population. However, data on vitamin D status of preterm infants in high‐risk populations, such as Middle Eastern countries is scarce. Methods: This study investigates the vitamin D status of Arab mothers and their preterm infants. Maternal serum and cord blood 25(OH)D, calcium (Ca), phosphorus (P) and alkaline phosphate (ALP) were measured at delivery. Serum 25(OH)D was measured by HPLC while the other biochemical parameters were measured by standard autoanalyzer. Results: Thirty‐four preterm infants were studied. The mean gestational age was 31.4 weeks and birth weight was 1667 g. The median serum 25(OH)D of 17.0 nmol/L in 28 mothers and 14.5 nmol/L in 34 cord blood samples were low. The median maternal and cord blood Ca, P and ALP levels were within normal range. Fifteen (44%) of the infants had moderately severe vitamin D deficiency (serum 25 (OH)D levels <12.5 nmol/L). The median serum 25(OH)D levels of mothers who had reportedly taken prenatal vitamin D supplementation and those who had not were similar (17.3 vs 16.3) nmol/L. The mean serum 25(OH)D levels among preterm infants in this study were low when compared to levels in Caucasians preterm infants on which the current vitamin D recommendations are based. Conclusion: The high prevalence of moderately severe vitamin D deficiency in Arab preterm infants provides a justification to investigate vitamin D requirement of preterm infants in this and other high‐risk populations.     

Polymorphonuclear leukocyte function in term and preterm newborn infants

Bacterial infections are a major problem in the care for newborn infants. In search for immunological deficits we investigated phagocytosis and killing of staphylococci using polymorphonuclear leukocytes (PMN) isolated from 2 ml of venous blood. Phagocytosis of PMN from preterm (n = 10) and newborn infants (n = 9; mean birth weights 1,949 and 3,523 g, respectively) was not different from that of adult PMN (n = 14). Killing capacity of PMN from preterm infants was markedly impaired compared to term newborn infants and to adult PMN. We found similar rates of superoxide anion production and similar times for activation in response to phorbolmyristate acetate stimulation. Our study gives further evidence that PMN from term newborn infants have normal phagocytotic and bactericidal capacity. In PMN from preterm newborn infants, however, the bactericidal capacity is diminished similar to newborn infants under stress as described earlier by others.     

Ghrelin and adiponectin levels in colostrum,cord blood and maternal serum

Background: Ghrelin and adiponectin, which are considered to take part in the regulation of energy metabolism, have been found in breast milk and cord blood. The aims of this study were to determine ghrelin and adiponectin levels in colostrum, cord blood and maternal serum and to investigate the correlations between colostrum and cord blood levels of these peptides and the anthropometry of newborn infants and their mothers. Methods: Total ghrelin (TGHR), free ghrelin (FGHR) and adiponectin levels were studied in colostrum and the serum samples of 25 healthy lactating women and the cord blood of their healthy full‐term infants. Results: No significant differences could be found among TGHR and adiponectin levels in colostrum, cord blood and maternal serum. The median FGHR level in colostrum was significantly higher than that of maternal serum and cord blood. The colostrum TGHR was negatively correlated with body mass index (BMI) and weight of the infants at birth. TGHR and FGHR levels in colostrum were found to be positively correlated with those of maternal TGHR and FGHR concentrations, respectively. Adiponectin levels in colostrum were not correlated with BMI or birthweight of the infants or BMI of the mothers. Conclusion: These findings suggest that the source of ghrelin in breast milk is probably both breast tissue itself and the serum of the mother. Ghrelin in colostrum seems to be related to the anthropometry of infants even at birth, unlike adiponectin.     

Vitamin E in human milk from mothers of preterm and term infants

The content of vitamin E (alpha- and beta + gamma-tocopherol) was analyzed in 63 human milk samples obtained from 13 mothers of preterm infants ("preterm" milk) and in 59 milk samples obtained from nine mothers of full-term infants ("term" milk). The changing pattern of the alpha- and beta + gamma-tocopherol content during the course of lactation was identical for both groups. Total vitamin E, alpha- as well as beta + gamma-tocopherol, decreased during the first 2 weeks of lactation and remained constant thereafter. The ratio of alpha- to beta + gamma-tocopherol decreased from about 10:1 to 4:1. At days 3 and 36 of lactation, vitamin E contents (median values and ranges) expressed as milligrams alpha-tocopherol equivalent per 100 ml were 1.45 (0.64-6.4) and 0.29 (0.17-0.48), respectively, for preterm and 1.14 (0.63-4.21) and 0.28 (0.19-0.86), respectively, for term human milk. The vitamin E, alpha-tocopherol and beta + gamma-tocopherol content of preterm human milk did not differ significantly (p less than or equal to 0.05) from that of term human milk at each sampling day. Based on these findings we conclude that the increased requirement of prematures for vitamin E is not reflected in the vitamin E content of milk from mothers delivering preterm infants.     

维生素D缺乏与早产儿坏死性小肠结肠炎的相关性

目的 评估维生素D水平对早产儿坏死性小肠结肠炎（NEC）的影响。方法 选取2016年1~12月于生后2 h内入新生儿科住院治疗的胎龄 < 36周的早产儿429例为研究对象,依据患儿是否发生NEC,将429例患儿分为NEC组（n=22）和非NEC组（n=407）。采集早产儿及其母亲入院时外周静脉血进行25-羟基维生素D（25-OHD）水平检测,比较两组早产儿和母亲血清25-OHD水平,Pearson相关分析早产儿和母亲血清25-OHD水平相关性,比较两组早产儿维生素D缺乏情况,单因素logistic回归分析早产儿NEC影响因素。结果 NEC组母亲和早产儿血清25-OHD水平均显著低于非NEC组（P < 0.001）。两组母亲和早产儿之间血清25-OHD水平均呈正向关（P < 0.001）。非NEC组与NEC组早产儿维生素D水平在正常、不足、缺乏、严重缺乏等状况的分布上比较差异有统计学意义（P < 0.001）。单因素logistic回归分析结果显示：胎龄、出生体重、母亲和早产儿25-OHD水平、机械通气持续时间、用氧持续时间和住院时间可能是NEC发生的影响因素（P < 0.05）。结论 母亲和早产儿低血清25-OHD水平与早产儿NEC的发生可能具有相关性,提示母孕期补充维生素D对于预防早产儿NEC的发生有重要意义。     

Serum growth-promoting activity measured as [3H]thymidine incorporation into human activated lymphocytes and serum transferrin levels in newborns and mothers

Serum growth-promoting activity measured as [3H]thymidine incorporation into human activated lymphocytes and serum transferrin levels were measured during the perinatal period in newborns and mothers. Both thymidine activity (TA) and transferrin levels were significantly increased at the time of delivery in mothers compared to control women, and there was a progressive return to control levels in the first 5 postpartum days. A significant correlation was found between TA and placental weight. In the newborns, TA was low in cord blood after vaginal delivery but not in the cord blood from babies born by cesarean section. In premature newborns, TA was lower than in full term newborns. In all newborns during the first 24 postnatal hours, there was an increase in TA with levels rising above adult control values: levels in cord blood were positively correlated with birth weight but not with thymidine activity. These data afford complementary insights into the humoral controls of growth in newborn infants.     

Serum concentration of granulocyte colony stimulating factor in term and preterm infants

We measured serum granulocyte colony stimulating factor (GCSF) concentration and absolute neutrophil count in four groups of infants: (1) 15 healthy term newborn infants; (2) 21 healthy preterm newborn infants, with mean (SD) birth weight 1583 (533) g, and gestational age 32.0 (3.8) weeks; (3) 5 infected newborn infants; (4) 22 6-month-old control infants. Median (range) serum GCSF concentration was 132.2 (41.5–176.0) pg/ml in term infants, 51.5 (1.8–175.7) pg/ml in preterm infants and 138.9 (54.1–449.8) pg/ml in 6-month-old control infants, with a significant reduction in preterm infants, as compared to term and control infants. GCSF levels were significantly higher in the infected infants, as compared to healthy neonates. Conclusion A significant positive relationship was found in term and preterm infants between serum GCSF concentration and gestational age or birth weight. No relationship was found between serum GCSF concen tration and neutrophil count. The low GCSF baseline levels may contribute to the increased incidence and severity of infection in preterm infants. Received: 17 May 1996 and in revised form: 20 July 1996 / Accepted: 29 July 1996     

Oral vitamin A, E and D supplementation of pre-term newborns either breast-fed or formula-fed: a 3-month longitudinal study

BACKGROUND: In contrast to the studies of vitamin A and E status in children, adolescents and adults, information on preterm infants is scarce. In the present investigation we examined the vitamin A, D and E status of pre-term infants at birth, and verified whether, at 1 and 3 months, breast or formula feeding affected the plasma concentration of those vitamins while being supplemented with Uvesterol ADEC. PATIENTS AND METHODS: In this prospective study, 2 groups of consecutively recruited preterm newborns fed either breast milk or formula received 3000 IU of vitamin A, 5 IU of vitamin E and 1000 IU of vitamin D daily. Vitamin A and E were measured by high performance liquid chromatography and spectrophotometry. 25-hydroxyvitamin D, a surrogate marker for vitamin D status, was measured by radioimmunoassay, and retinol binding-protein concentration was measured by immunonephelometry. RESULTS: At birth, formula-fed and breast-milk fed infants had similar plasma concentrations of vitamin A (0.75 +/- 0.20 and 0.64 +/- 0.21 micromol/L, ns), 25-hydroxyvitamin D (34.4 +/- 25.6 and 47.5 +/- 26.7 nmol/L, ns) and vitamin E (9.5 +/- 3.2 and 8.4 +/- 3.3 micromol/L, ns). Vitamins A and E, and retinol binding-protein concentrations steadily increased with time in both groups of infants without attaining, at 3 months, values considered normal in term infants and in young children. At 3 months of age, concentrations of 25-hydroxyvitamin D reached values comparable to those observed in term infants. CONCLUSION: Plasma concentrations of vitamins A and E and of retinol binding-protein steadily increased during the the study without reaching full repletion values. At the conclusion of the study, the type of nutrition did not affect plasma vitamin concentrations.     

THE EFFECT OF VITAMIN E ON ERYTHROCYTE HEMOLYSIS AND LIPID PEROXIDATION IN NEWBORN PREMATURE INFANTS

ABSTRACT. The biochemical effect of vitamin E supplementation to mothers with threatened premature delivery and to premature infants after birth has been studied. Although a weak correlation was found between maternal and cord blood vitamin E levels at birth, cord blood levels were not significantly higher in the infants from supplemented mothers than those from unsupplemented mothers. Furthermore, maternal vitamin E treatment did not prevent either erythrocyte hemolysis or lipid peroxide formation in the premature infants after birth. On the other hand, intramuscular vitamin E to infants after birth produced a marked biochemical effect, with both zero erythrocyte hemolysis and low lipid peroxide formation when serum vitamin E increased above 2 mg/100 ml. We conclude that intramuscular vitamin E immediately after birth is necessary to achieve a biochemical effect of vitamin E in the early neonatal period. (No cases of retrolental fibroplasia occurred in the present study.)     

Vitamin E status in preterm infants fed human milk or infant formula

Vitamin E status was assessed in 36 infants with birth weights less than 1500 gm who were assigned randomly to receive one of three sources of nutrition: milk obtained from mothers of preterm infants (preterm milk), mature human milk, or infant formula. Infants in each dietary group were further assigned randomly to receive iron supplementation (2 mg/kg/day) beginning at 2 weeks or to receive no iron supplementation. All infants received a standard multivitamin, providing 4.1 mg alpha-tocopherol daily. Serum vitamin E concentrations at 6 weeks were significantly related both to type of milk (P less than 0.0001) and to iron supplementation (P less than 0.05). Infants fed preterm milk had significantly higher serum vitamin E levels than did infants fed mature human milk, and both groups had significantly higher levels than did those fed formula. Ratios of serum vitamin E/total lipid were also significantly greater for infants fed human milks than for those fed formula. The addition of iron to all three diets resulted in significantly lower serum vitamin E levels at 6 weeks (P less than 0.05); however, only in the group fed formula was there evidence of vitamin E deficiency. Preterm milk with routine multivitamin supplementation uniformly resulted in vitamin E sufficiency in VLBW infants whether or not iron was administered.     

High prevalence of vitamin D deficiency in newborn infants of high-risk mothers.

OBJECTIVE: To determine the prevalence of vitamin D deficiency in newborn infants of mothers at risk of vitamin D deficiency because of dark skin or the wearing of concealing clothes (such as a veil) compared with a group presumed not to be at risk. A second aim was to correlate these newborn infants' vitamin D concentrations with biochemical parameters of vitamin D metabolism and bone turnover at birth. DESIGN: A prospective study conducted between April 2004 and February 2006 including women delivering during this period and their newborn infants. SETTING: The outpatient clinic of the obstetrics department, Sint Franciscus Gasthuis, Rotterdam, the Netherlands. PATIENTS: Eighty seven newborn infants of healthy mothers with either dark skin and/or concealing clothing (risk group) or light skin (control group). RESULTS: We found a significant difference in the prevalence of vitamin D deficiency (25-hydroxyvitamin D(3) <25 nmol/l) between newborn infants of mothers at risk and those of mothers in the control group (63.3% vs 15.8%; p<0.001). Mean alkaline phosphatase concentrations were significantly higher in the at risk group. CONCLUSIONS: Newborn infants of mothers with dark skin or wearing concealing clothes are at great risk of vitamin D deficiency at birth. The clinical implications are unknown. Further research is necessary to determine the long-term consequences of maternal and neonatal vitamin D deficiency so that guidelines on vitamin D supplementation during pregnancy can be issued.     

Serum Vitamin A Levels in Mothers and Their Breast-Fed Term Infants with or without Supplemental Vitamin A

ABSTRACT. Serum concentrations of vitamin A were measured in term infants ( n =72) and their mothers at delivery and after 20 weeks of breast-feeding ( n =48). During the 20 weeks the infants received either no supplemental vitamin A (but the mothers were given 3000 IU vitamin A daily) ( n =16) or a daily vitamin A supplementation of 600 ( n =17) or 1500 IU ( n =15). After 20 weeks of breast-feeding the vitamin A levels in the unsupplemented infants were similar to those at birth. The infants supplemented either with 600 or 1500 IU had higher vitamin A serum levels than at birth ( p <0.01), however, there was no difference between the two supplemented groups. During lactation, the serum vitamin A concentrations of the mothers increased significantly in all groups with or without vitamin A supplementation.     

Serum vitamin A levels in mothers and their breast-fed term infants with or without supplemental vitamin A

Serum concentrations of vitamin A were measured in term infants (n = 72) and their mothers at delivery and after 20 weeks of breast-feeding (n = 48). During the 20 weeks the infants received either no supplemental vitamin A (but the mothers were given 3,000 IU vitamin A daily) (n = 16) or a daily vitamin A supplementation of 600 (n = 17) or 1,500 IU (n = 15). After 20 weeks of breast-feeding the vitamin A levels in the unsupplemented infants were similar to those at birth. The infants supplemented either with 600 or 1,500 IU had higher vitamin A serum levels than at birth (p less than 0.01), however, there was no difference between the two supplemented groups. During lactation, the serum vitamin A concentrations of the mothers increased significantly in all groups with or without vitamin A supplementation.     

Erythrocyte insulin binding in preterm newborn infants

To characterize the erythrocyte insulin receptor in newborn infants we studied the binding of 125I-insulin to the erythrocytes from 42 preterm infants (14 at birth, 14 aged 2-7 days, and 14 aged 8-16 days) with a mean gestational age of 34.1 wk, and from 32 term infants (16 at birth and 16 aged 2-7 days). The insulin binding to cord blood erythrocytes from preterm infants was significantly higher than that of cord blood cells from term infants and to postnatal cells from preterm as well as term infants. The erythrocytes from preterm infants aged 2-7 days bound more insulin than cells from preterm infants aged 8-16 days. The maximum insulin binding (specific insulin binding at tracer concentration of insulin) correlated negatively with the gestational age both at birth and over the 1st postnatal wk. In the preterm infants there was a strong negative correlation between the maximum insulin binding and postnatal age. The enhanced insulin binding to cord blood erythrocytes from preterm infants was due to both an increased receptor concentration and a high affinity for insulin. The increased affinity persisted over the 1st wk of life. In preterm infants older than 1 wk the insulin binding characteristics were basically similar to those in term newborn infants. In all infants studied the receptor concentration seemed to be postnatal age dependent while the receptor affinity was gestational age dependent. No correlation was found between the insulin binding data and the plasma concentrations of immunoreactive insulin or C-peptide.(ABSTRACT TRUNCATED AT 250 WORDS)