Measurement of interleukin-6 (IL-6) and erythropoietin (EPO) in umbilical cords of preterm infants with intraventricular hemorrhage in two hospitals in Tehran

Background: Intraventricular hemorrhage (IVH) is an important cause of death in premature infants. This study aimed to assess the association of the umbilical cord plasma levels of interleukin-6 (IL-6) and erythropoietin (EPO) with the occurrence and severity of IVH in premature infants.

Methods: Fifty premature newborns of mothers with chorioamnionitis risk factor were selected via nonprobability sampling. The concentration of the cord plasma’s IL-6 and erythropoietin were measured by enzyme-linked immunosorbent assay (ELISA) for 3 days. Finally, all samples underwent sonography for the diagnosis of IVH. Results analyzed statistically.

Results: Among the samples, 68.98% of them were diagnosed with IVH grade 1. The most severe IVH cases were detected on the second day. The mean and standard deviation of IL-6 level was 74.71?±?50.53 in the case group and 24.10?±?46.10 in the control group. There was a correlation between IL-6 levels and IVH (p?=?0.0005). The mean and standard deviation of EPO level was 18.38?±?15.23 in the IVH group and 6.45?±?13.48 in samples without IVH. A correlation was detected between EPO level and IVH (p?=?0.005).

Conclusion: The concentration of IL-6 and EPO levels of the cord plasma was higher in the premature newborns with IVH.     

Superior vena cava flow and intraventricular haemorrhage in extremely preterm infants

Objective: To evaluate the relationship between superior vena cava flow (SVCF) measurements within the first 24?h of life, and development of intraventricular haemorrhage (IVH) in extremely preterm infants.

Study design: Single centre retrospective cohort study of 108 preterm infants born less than 28 weeks’ gestation. Main outcome measure was degree of IVH at day 7 postnatal age.

Results: The mean GA of the study group was 25.4 weeks. Mean SVCF was lower (75?ml/kg/min) in infants later diagnosed with IVH (n?=?46) compared to infants, who did not develop IVH (87.7?ml/kg/min, p?=?0.055). PDA diameter was inversely associated with SVCF (p?=?0.024) and reversal of flow in the descending aorta (p?=?0.001). Sensitivity analysis did not confirm an independent association of SVCF with development of IVH [OR 0.990 (0.978–1.002), p?=?0.115].

Conclusion: Our study describes early SVCF in extremely preterm infants is associated with the extent of ductal shunting, but insensitive in predicting IVH.     

The use of 17-hydroxy progesterone in women with arrested preterm labor: a randomized clinical trial

Abstract

Background: The use of 17-alpha-hydroxyprogesterone caproate (17?P) has been shown to reduce preterm delivery in women who have had a prior preterm birth. The role of 17?P in women with arrested preterm labor is less certain.

Aims: To compare the preterm birth rate and neonatal outcome in women with arrested preterm labor randomized to receive 17?P or placebo.

Materials and methods: Women with arrested preterm labor were randomized to weekly injections of either 17?P (250?mg) or placebo. Maternal and neonatal outcome were evaluated.

Results: Forty-five singleton pregnancies were randomized after successful tocolysis; 22 received 17?P while 23 got placebo. Gestational age at delivery (p?=?0.067) and the interval from treatment to delivery (p?=?0.233) were not affected by 17?P. Significantly less women in the 17?P group delivered at <34 weeks (14 versus 21, p?=?0.035). There was also a significant reduction in the risk of neonatal sepsis (p?=?0.047) and gr III/IV intraventricular hemorrhage (IVH) (p?=?0.022) in the 17?P group.

Conclusion: In this study, 17?P did not delay the interval to delivery after successful preterm labor, but births <34 weeks as well as neonatal sepsis and IVH were reduced by 17?P treatment.     

The effect of histological chorioamnionitis on the short-term outcome of preterm infants ≤32 weeks: a single-center study

Abstract

Background and objectives: Chorioamnionitis (CA) is an acute inflammation of the membranes and chorion of the placenta. The aim of this study was to determine the effect of histological CA on the short-term outcome of preterm infants.

Subjects and methods: The clinical characteristics and outcomes of the preterm infant including respiratory distress syndrome, duration of mechanical ventilation, patent ductus arteriosus (PDA) requiring medical treatment or ligation, necrotizing enterocolitis, bronchopulmonary dysplasia, death and intraventricular hemorrhage (IVH; grade III–IV) were analyzed.

Results: Two hundred and eighty-one infants born at ≤32 weeks gestational ages were included. Infants were divided into two groups: one with histological CA (n?=?145) and without histological CA (n?=?136). Mean gestational age was 28.8?±?2.6 weeks and 29.1?±?2.5 weeks, and mean birth weight was 1138?±?350?g and 1210?±?299?g, respectively. There were no differences in gestational age and birth weight among the groups. Compared with the group, histological CA was associated with early onset sepsis (p?=?0.007), PDA (p?=?0.003), IVH (p?=?0.03), and death (p?=?0.04).

Conclusion: Maternal histological CA is an important risk factor for preterm deliveries and associated with serious morbidities such as early onset sepsis, IVH, PDA and increased mortality.     

Investigation of maternal and cord blood erythropoietin and copeptin levels in low-risk term deliveries complicated by meconium-stained amniotic fluid

Objective: To compare maternal, cord blood erythropoietin (EPO), and copeptin levels in low-risk term deliveries which are complicated by meconium-stained amniotic fluid (MSAF) to those with clear amniotic fluid. Also, to evaluate the relations between these markers and cord blood pH values.

Methods: Low-risk term pregnant women with MSAF at an active phase of labor were defined as the study group (n?=?39). Pregnant women with clear amniotic fluid were selected for the control group (n?=?41). The two groups were matched for age, body mass index and gestational age. Maternal, cord blood EPO and copeptin levels with cord blood pH values were also measured.

Results: Maternal, cord blood EPO, and copeptin levels of study and control groups were 42.6?±?9.0 versus 40.7?±?9.2, 134.2 (20.5–834.6) versus 38.4 (10.3–114.2), 4.9 (0.1–31.1) versus 4.0 (3.1–28.4), and 4.7 (2.6–25.5) versus 3.6 (2.0–23.2), respectively. The differences were statistically significant for cord blood EPO, maternal and cord blood copeptin levels (p?p?=?0.004, p?p?p?p?=?0.005, and p?=?0.009, respectively).

Conclusion: We suggest that higher cord blood EPO and maternal and cord blood copeptin levels may be an indicator of fetal acidosis in low-risk term deliveries complicated by MSAF.     

Effect of maternal and neonatal interleukin-6 − 174 G/C polymorphism on preterm birth and neonatal morbidity

Objective: The aim of this study was to analyze maternal and neonatal interleukin 6 (IL-6) (?174?G/C) polymorphism and to determine effect on preterm birth and neonatal morbidity.

Study Design: One hundred and sixty-four mothers (100 term births, 64 preterm births) and 183 newborn infants who were 100 healthy term and 83 preterm babies followed in newborn intensive care units were evaluated. PCR-RFLP was performed for IL-6 (?174?G/C) genotyping.

Results: The rate of GG genotype in mothers of term and preterm infants were 54% (n?=?54/100), 75% (n?=?48/64), respectively (p?>?.05) and the rate of GC?+?CC genotype was 46% (n?=?46/100) and 25% (n?=?16/64) in mothers giving term and preterm birth (PTB), respectively (p?n?=?65/100) and 81.9% (n?=?68/83) in term infants and preterm infants, respectively. GC?+?CC genotype was 35% (n?=?35/100) in term infants and 18.1% (n?=?15/83) in preterm infants (p?Conclusion: The IL-6 174?G/C gene polymorphism was significantly different between mothers who were giving to term and preterm birth. The presence of polymorphism is protective against preterm birth and was not associated with neonatal outcome.     

The relationship between amniotic and newborn gastric fluid inflammatory mediators

Abstract

Objective: To determine whether the levels of inflammatory mediators in gastric fluid (GF) of a premature newborn are associated with those in amniotic fluid (AF) of the newborn’s mother.

Patients: Twenty-three pairs of pregnant women and their premature newborns <35 weeks gestation, born by Cesarean sections.

Methods: Amniotic fluids and newborn gastric fluids were obtained from women during Cesarean section procedure. The mother-premature newborn dyads were retrospectively assessed to analyze the clinical and laboratory data. Concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-α) and mannose-binding lectin (MBL) were compared between amniotic and newborn gastric fluids in each dyad.

Results: Premature newborns and their mothers with funisitis had significantly higher median AF IL-6, TNF-α and GF IL-8 concentrations than those without funisitis (p?=?0.022 for AF IL-6; p?=?0.023 for AF TNF-α; p?=?0.022 for GF IL-8). The concentrations of IL-6, IL-8, TNF-α and MBL in newborn GF were significantly correlated with those in AF in each dyad (p?<?0.001, r?=?0.872 for IL-6; p?<?0.001, r?=?0.851 for IL-8; p?<?0.001, r?=?0.768 for TNF-α; p?<?0.001, r?=?0.845 for MBL, respectively).

Conclusion: The levels of inflammatory mediators in GF of a premature newborn immediately after birth are strongly associated with those in AF of the newborn’s mother.     

Vitamin D deficiency in Egyptian mothers and their neonates and possible related factors

Abstract

Objective: To correlate vitamin D level in Egyptian mothers with that of their newborns, and examine risk factors related to maternal vitamin D deficiency.

Methods: A cross-sectional study was carried out at the university teaching hospital in Cairo, Egypt. Serum 25(OH) D levels were measured by enzyme-linked immunosorbent assay in 135 pregnant women at ≥37 weeks’ gestation immediately before delivery and in cord blood of their newborns.

Results: The levels of serum 25(OH) D were 32.6?±?21.4?ng/ml in mothers and 16.7?±?10?ng/ml in their newborns. Maternal vitamin D level was strongly correlated with that of the newborns (r?=?0.7, p?<?0.0001). Maternal vitamin D deficiency/insufficiency and neonatal vitamin D deficiency/insufficiency were encountered in (40%, 28.9% and 60%, 32.6% respectively). Maternal vitamin D levels showed significant correlations with maternal body mass index (BMI; r?=??0.201, p?=?0.021), gestational age at delivery (r?=?0.315, p?≤?0.0001), fish consumption (r?=?0.185, p?=?0.032), educational level (r?=?0.29, p?=?0.001), and skin exposure (r?=?0.247, p?=?0.004).

Conclusion: Maternal vitamin D levels strongly correlate with neonatal levels. Maternal vitamin D deficiency is a real problem in Egypt; this is generally related to high BMI, low fish consumption, low educational level, and limited skin exposure.     

Maternal cytokines and disease severity influence pregnancy outcomes in women with rheumatoid arthritis

Objectives: To assess the influence of maternal cytokine levels, disease activity and severity on preterm delivery, small for gestational age (SGA) and cesarean delivery in pregnant women with rheumatoid arthritis (RA).

Methods: A prospective study in 47 pregnant women with RA and 22 healthy pregnant controls. The main outcome measures were birth weight in relation to maternal serum levels of interleukin-6 (IL-6), interleukin-10 (IL-10), and RA activity and severity at three different time points: preconception and during the first and third trimesters.

Results: During the third trimester, IL-10 was detectable in 23.4% of patients with RA, IL-6 in 76.6%. Mean birth weight born to mothers with RA was higher when IL-10 level was high compared with low (p?=?0.001), and lower when IL-6 was high compared with low (p?=?0.035). Also increase in disease activity score-28 (in 60.1%, p?=?0.001), Health Assessment Questionnaire–Disability Index (in 87.5%, p?=?0.013), and pain score (56.9?±?11.4, p?=?0.003) associated with increased risk of SGA. High patient’s global scale was associated with unfavorable pregnancy outcome (preterm, SGA, and cesarean).

Conclusion: High maternal IL-10 levels are associated with higher birth weight and high IL-6 levels are associated with lower birth weight (SGA). Among women with RA, disease activity and severity are predictive of unfavorable pregnancy outcomes suggesting that better disease management early in the pregnancy could improve pregnancy outcomes.     

Comparison of changes in etiologic microorganisms causing early-onset neonatal sepsis between preterm labor and preterm premature rupture of membranes

Objective: To investigate changes in the etiologic microorganisms causing early-onset neonatal sepsis (EONS) in preterm labor (PTL) or preterm premature rupture of membranes (pPROM) cases over the past 16 years and to analyze the associated factors.

Methods: We included consecutive singleton pregnancies delivered before 34 weeks due to PTL or pPROM. The etiologic microorganisms causing EONS in PTL and pPROM cases were compared between period 1 (1996–2004) and period 2 (2005–2012).

Results: There was no difference in the incidence of Gram-positive bacteria causing EONS between period 1 and 2, either in PTL (2.0% versus 2.1%, p?=?1.0) or in pPROM (1.5% versus 1.6%, p?=?1.0). However, the incidence of EONS caused by Gram-negative bacteria was significantly increased in pPROM (0.6% versus 2.7%, p?=?0.040) during period 2, compared to period 1; but not in PTL (0.3% versus 1.2%, p?=?0.211). Multivariable analysis revealed that a prolonged ROM-to-delivery interval (>7?d) was significantly associated with EONS caused by Gram-negative bacteria in pPROM (odds ratio: 6.6, 95% confidence interval: 1.4–31.8, p?=?0.018).

Conclusions: The etiologic microorganisms causing EONS have changed over the past 16 years in pPROM cases but not in PTL cases.     

Method of delivery and intraventricular haemorrhage in extremely preterm infants

Objectives.?It has been reported that caesarean delivery (CD) protects against intraventricular haemorrhage (IVH) in the extremely preterm infant, but it is not known whether this effect involve the more severe grades of IVH. Thus, our aim was to confirm the correlation between the occurrence of IVH and the mode of delivery, and to evaluate this correlation for each grade of IVH.

Methods.?All infants with gestational age (GA)?≤?28 weeks admitted to the neonatal intensive care unit of a tertiary hospital were studied for each grade IVH and major complications rate.

Results.?We found that vaginally born infants had a higher rate of each grade of IVH, but the increase was statistically significant only for grade 3 IVH (18% vs. 2%, p?<?0.0001) and all grades IVH (45% vs. 20%, p?<?0.0001). Multivariate analysis demonstrated that CD (RR: 0.42, 95% CI 0.28–0.63), birth weight?≥?800?g (RR: 0.48, 95% CI 0.32–0.73), 27–28 weeks of GA (RR: 0.38, 95% CI 0.25–0.60) and antenatal steroids (0.66, 95% CI 0.22–0.46) decrease independently the risk of developing IVH.

Conclusions.?Our study demonstrates that CD decreases the risk of developing IVH in extremely preterm infants including the most severe grades of IVH.     

Effects of lutein supplementation on biological antioxidant status in preterm infants: a randomized clinical trial

Abstract

Objective: To test the hypothesis that lutein, compared to the placebo, would enhance the total antioxidant status (TAS) in the preterm infants.

Methods: Infants with gestational age (GA) ≤34 weeks were randomly assigned to receive a daily dose of lutein and zeaxanthin (0.5?mg?+?0.02?mg/kg/d) or placebo from the 7th day of life until 40th week of postmenstrual age or until discharge.

Results: Seventy-seven preterm infants were randomized (38 in the Lutein group and 39 in the Placebo group) with mean GA of 30.4 (±2.3) weeks and the mean birth weight of 1415 (±457) grams. The TAS did not result statistically different between the two groups during all the study period, but a significant linear correlation was evidenced between plasma lutein concentration and TAS (r?=?0.14, p?=?0.012) and between plasma zeaxanthin concentration and TAS (r?=?0.13, p?=?0.02).

Conclusions: Supplementation of preterm infants with orally lutein was ineffective in enhancing biological antioxidant capacity. Further studies need to better understand the bioavailability of lutein in the neonatal period in order to identify any best form of supplementation.

Trial registration number: UMIN000007041.     

Comparison of hematologic indices and markers of infection in umbilical cord and neonatal blood

Abstract

Objective: Evaluation of a neonate for suspected early neonatal sepsis routinely includes blood tests such as complete blood count, C-reactive protein (CRP) and culture. In order to obviate the need for venepuncture, we prospectively compared these tests in paired samples from umbilical cord and peripheral venous blood drawn during the first hours after birth in both preterm and term infants.

Methods: Paired blood samples were studied from asymptomatic neonates with risk factors for early sepsis. Data were collected on maternal and neonatal factors that may have influenced the correlation between the tests.

Results: Three hundred fifty pairs of samples were studied. Significant correlation between umbilical cord and peripheral venous samples was found for white blood cell (WBC; r?=?0.683) and platelets (PLT) (r?=?0.54). Correlation for hemoglobin was lower (r?=?0.36). No cases of early neonatal sepsis were detected. However, contamination rates were 12% in umbilical cord blood and 2.5% in peripheral venous blood cultures. WBC rose after birth and the 90th percentile rose from 22?500 in umbilical cord blood to 29?700 in peripheral blood.

Conclusions: Screening for sepsis with umbilical cord CBC may be useful provided normal ranges are adjusted accordingly.     

Maternal serum concentrations of s-Endoglin and IL-6 in pregnancy complicated by preterm premature membrane rupture

Objective: This study aimed to investigate maternal serum concentrations of s-Endoglin and compare s-Endoglin with other inflammatory markers in prediction of time to delivery, in pregnancies complicated by preterm premature rupture of membranes (PPROM).

Materials and methods: Fifty five patients complicated by PPROM whose gestational age were between 2433 weeks and 44 matched healthy pregnant women were included in present study. Maternal concentrations of s-Endoglin concentrations were measured by an enzyme-linked immunosorbent assay (ELISA) and compared with maternal inflammatory markers including interleukin-6 (IL-6), white blood cell (WBC) count and serum C-reactive protein (CRP). The best variable for prediction of preterm birth was computed.

Results: Mean s-Endoglin levels in PPROM were lower than control groups (0.24?±?0.12?pg/ml and 0.69?±?0.25?pg/ml, respectively, p?<?0.01). Besides IL-6 (p?<?0.01), WBC (p?=?0.016) and CRP (p?=?0.010) levels were higher in PPROM group. In PPROM group, ROC analysis results of s-Endoglin for prediction of preterm delivery <48 h, <7 days, <32 weeks were not different (p?>?0.05). For predicting preterm birth before 48 h and 7 days, only IL-6 at cut off value >0.70 (pg/ml) and >0.55 (pg/ml) had area under curve (AUC); 0.871 (0.7750.965), p?<?0.01, AUC; 0.925 (0.8560.993), p?<?0.001, respectively.

Conclusion: s-Endoglin as an anti-angiogenic marker seemed to have a role in pathogenesis but results of present study showed that, unlike IL-6, it was unsatisfactory for estimating time to delivery in PPROM.     

Total energy intake accounts for postnatal anthropometric growth in moderately/late preterm infants

Objective: Moderately preterm (MP) (32–33 weeks) and late preterm (LP) (34–36 weeks) infants have higher risks of mortality and growth and developmental problems. We, herein present a new concept of nutritional assessment, total energy intake (TEI), which is the sum total of kilocalories administered in all nutrient forms.

Methods: Fifty-two preterm infants were classified as MP (n?=?12), LP/appropriate for gestational age (LP/AGA) (n?=?33), or LP/small for gestational age (LP/SGA) (n?=?7). All groups received nutrient therapy by the same protocol. The sum of the daily energy intake at 14 and 28 days after birth was determined.

Results: TEI was 2822.1?±?162.1?kcal/kg/28 days in the MP group, 3187.2?±?265.0?kcal/kg/28 days in the LP/AGA group and 3424.6?±?210.4?kcal/kg/28 days in the LP/SGA group. In all groups, TEI for 28 days was significantly correlated with body weight gain (r?=?0.465, p?=?0.006). TEI for 14 days after birth was inversely correlated with the body weight loss rate after birth (r?=??0.491, p?=?0.0002).

Conclusion: TEI was well correlated with anthropometric changes after birth. TEI may be used to effectively assess preterm infants’ nutritional needs.     

Effect of early versus conventional epidural analgesia during labor on cytokine production

Abstract

Objective.?To compare the effect of early epidural analgesia (EEA) vs. conventional epidural analgesia (CEA) on cytokine production in mother and neonate.

Methods.?Healthy parturients with uncomplicated term pregnancies were randomized into two groups: EEA – parturients who would receive epidural analgesia before onset of pain and the control group, CEA – parturients who would receive epidural analgesia after onset of pain. Cytokines were measured in maternal blood at randomization Visual Analog Scale (VAS) < 30], 24 h postpartum, and in cord blood.

Results.?Forty-one women were studied. Epidural was performed in EEA when VAS was 23 ± 10 and in CEA when VAS was77 ± 10 (p < 0.0001). Background data were similar except for ruptured membranes at admission (EEA 15%, CEA 46.6%; p?=?0.03), transient hypotension (EEA 20%, CEA 0%; p?=?0.03), and meconium (EEA 25%, CEA 0%; p?=?0.01). No significant differences were found in cytokine levels between groups at any time. Interleukin (IL)-6 levels changed significantly only in the control group (p?=?0.046). There was significant correlation between baseline maternal IL-6 level and cord blood level in CEA (r?=?0.59, p?=?0.005), while no significant correlation existed in EEA (r?=?0.33, p?=?0.16).

Conclusion.?Although there was no significant difference in cytokine levels between the groups, EEA prevented the significant increase in IL-6 during labor and interrupted IL-6 fetal-maternal dependency.     

Neurodevelopmental outcomes of premature infants with severe intraventricular hemorrhage

Objective: Our objective was to determine the neurodevelopmental outcome at 18–24 months’ of corrected age (CA) in preterm infants with severe intraventricular hemorrhage (IVH).

Methods: This was a retrospective cohort study of all preterm infants who were <37 weeks’ gestation, had Grade 3–4 IVH, were admitted between January 2009 and December 2010 and discharged. The cohort was divided into three groups. Group 1 was defined as infants born with a birth weight (BW) less than 1000?g, group 2 was defined as infants born with a BW between 1000 and 1500?g and group 3 was defined as infants born with a BW between 1501 and 2500?g. Severe IVH was defined as the presence of grade 3–4 IVH on cranial ultrasound. Cranial ultrasound was performed in the first week of life and subsequently at weekly intervals by a radiologist. A comprehensive assessment including hearing, vision, neurological and developmental evaluation with Bayley Scales of Infant Development, Second edition was performed by the experienced researchers at 18–24 months’ CA. Neurodevelopmental impairment (NDI) was defined as at the presence of one or more of the following: cerebral palsy; Mental Developmental Index score lower than 70; Psychomotor Developmental Index score lower than 70; bilateral hearing impairment; or bilateral blindness.

Results: From January 2009 to December 2010, a total of 138 infants were diagnosed as severe IVH (grade 3–4). Of them, 74 (71.1%) infants (group 1?=?31, group 2?=?29 and group 3?=?14 infants) completed the follow-up visit and evaluated at 18–24 months’ CA. Median Apgar score (p?p?p?p?p?p?p?=?0.014, respectively). The duration of hospitalization and mortality rates consistent with the degree of prematurity were significantly higher in group 1 compared to groups 2 and 3 (p?=?0.03 and p?=?0.01). Among the long-term outcomes, the rates of CP and NDI did not differ between the groups (p?=?0.68 and p?=?0.068).

Conclusion: Our results demonstrated that long-term outcomes of preterm infants did not differ between the groups classified according to the BW at two years of age. This has leaded to the conclusion that severe IVH is alone represents a significant risk factor for poor neurodevelopmental outcome in this already high-risk population.     

Low-mannose-binding lectin levels in susceptibility to neonatal sepsis in preterm neonates with fetal inflammatory response syndrome

Aim.?In this study, we aimed to evaluate cord blood mannose binding levels (MBL), to evaluate possible relationship between cord blood MBL levels with neonatal sepsis and culture confirmed neonatal sepsis in preterm newborn with gestational age below 34 weeks with fetal inflammatory response syndrome (FIRS).

Methods.?Forty-four randomly selected ≤34 weeks gestational age newborns with FIRS were evaluated. MBL deficiency was described as cord blood levels were below 400?ng/ml.

Results.?Mean value of umbilical cord MBL was significantly lower in newborns with culture confirmed sepsis (p?<?0.01) and also all cases with sepsis (including culture negative or positive) (p?<?0.05) than newborns without sepsis. Culture-confirmed sepsis was statistically common in MBL deficient premature newborns with FIRS. Univariate analysis showed that gestational age, birth weight, low serum MBL level and poor obstetric history were all significantly associated with the risk of neonatal sepsis. A subsequent multivariate analysis showed that the association between serum MBL level and the risk of suspected sepsis and culture confirmed sepsis independently from gestational age and birth weight.

Conclusion.?Here in, we report firstly lower MBL levels were found related with sepsis in neonates, especially in newborns with culture proven sepsis. Low MBL levels may help to identify neonates with FIRS at high risk of developing sepsis.     

Serum leptin concentration in cord blood: relationship to birth weight and gender in pregnancies complicated by pre-eclampsia

The aim of the study was to investigate cord blood leptin concentrations and their relationship to birth weight and gender in term pregnancies complicated by pre-eclampsia.

Cord blood samples were obtained from 52 women, identified as having pre-eclampsia, and their newborns (31 males and 21 females) immediately after birth. Specimens were analyzed using a human leptin¹²⁵ I radioimmunoassay. The relationship between leptin and anthropometrics was assessed by Spearman correlation. Differences in cord blood leptin levels between male and female infants were tested with the Mann- Whitney U test. The correlation between leptin and gender was computed using the productmoment-biseral correlation analysis for continuous and dichotomous variables. The multiple logistic regression analysis examined influences of sex, birth length, birth weight, birth weight/birth length ratio, ponderal index and maternal leptin as covariates on the fetal cord leptin level.

Fetal leptin correlated positively with birth weight, length and weight/length ratio, in the total group and in the male subgroup and additionally with ponderal index in the female subgroup. Cord blood leptin concentrations in female newborns were significantly higher than in male newborns (p = 0.015), and concentrations correlated with gender (r =-0.315; p = 0.023). Multiple logistic regression analysis revealed four potential independent factors influencing fetal cord leptin: gender, birth weight, birth weight/birth length ratio and maternal leptin.

In conclusion, cord leptin concentrations in pregnancies complicated by pre-eclampsia correlate positively with birth weight and gender. Leptin concentrations in female newborns are higher compared to male newborns.     

Umbilical cord asymmetric dimethylarginine levels and ultrasound assessment of carotid arteries in neonates born small for gestational age

Background: To examine asymmetric dimethylarginine (ADMA) level as an endothelial function parameter in addition to ultrasonographic evaluation of carotid arteries in babies born small for gestational age (SGA).

Methods: Twenty-six neonates born SGA and 34 appropriate for gestational age (AGA) controls were included in the study. The serum levels of ADMA were measured. Intima-media thickness (cIMT) and resistive index (cRI) of the both carotid arteries were determined by ultrasonography.

Results: The mean ADMA level was higher in SGA neonates compared to AGAs (16 267.7?±?6050 versus 12 810.2?±?3302?ng/L; p?=?0.01). The mean cIMT (0.34?±?0.02 versus 0.31?±?0.03?mm; p?=?0.001) and cRI (0.66?±?0.07 versus 0.61?±?0.04, p?=?0.003) were also higher in SGAs. Serum ADMA levels were positively correlated to the mean cIMT (r?=?0.41, p?=?0.001). Although there was a weak correlation between cIMT and mean cRI (r?=?0.26, p?=?0.04), no correlation was found between ADMA and mean cRI (r?=?0.17, p?=?0.18).

Conclusions: Neonates born SGA have elevated cord blood ADMA level in addition to thicker IMT and higher RI of carotid arteries at birth. ADMA was correlated to cIMT, suggesting that higher ADMA levels might influence vascular health in later life in these neonates.