Fresh-frozen plasma as a source of exogenous insulin-like growth factor-I in the extremely preterm infant

Ingrid Hansen-Pupp1, Eva Engström, Aimon Niklasson

  • 1Division of Pediatrics, Department of Clinical Sciences Lund, Lund University Hospital, 221 85 Lund, Sweden. ingrid.pupp@skane.se

Insights

Fresh-frozen plasma (FFP) transfusions significantly increase insulin-like growth factor-I (IGF-I) and IGF binding protein-3 (IGFBP-3) levels in extremely preterm infants. This intervention helps restore crucial proteins important for neurodevelopment and blood vessel growth.

Area of Science:

  • Neonatology
  • Pediatric Endocrinology
  • Transfusion Medicine

Background:

  • Preterm birth is associated with reduced levels of IGF-I and IGFBP-3, critical for neurogenesis and angiogenesis.
  • Maintaining adequate IGF-I and IGFBP-3 levels is vital for the development of extremely preterm infants.

Purpose of the Study:

  • To investigate the impact of fresh-frozen plasma (FFP) transfusions on circulatory IGF-I and IGFBP-3 levels in extremely preterm infants.
  • To assess the efficacy of FFP administration in normalizing key growth factor levels.

Main Methods:

  • A prospective cohort study involving 20 extremely preterm infants requiring FFP transfusion.
  • Blood samples were collected before and at multiple time points after FFP transfusion to measure IGF-I and IGFBP-3 concentrations.

Main Results:

  • FFP transfusion led to a significant increase in IGF-I (133%) and IGFBP-3 (61%) levels immediately post-transfusion.
  • Elevated levels of both IGF-I and IGFBP-3 were sustained for up to 12 hours after transfusion.
  • The estimated half-life of administered IGF-I was approximately 3.4 hours per kilogram of infant weight.

Conclusions:

  • FFP transfusion is an effective method for increasing IGF-I and IGFBP-3 levels in extremely preterm infants.
  • This intervention may support the neurodevelopmental and angiogenic processes in this vulnerable population.
Abstract