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Perinatal systemic inflammatory responses of growth-restricted preterm newborns

T F McElrath1, E N Allred, L Van Marter

  • 1Department of Obstetrics and Gynecology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. tmcelrath@partners.org

Acta Paediatrica (Oslo, Norway : 1992)
|July 4, 2013
PubMed

Insights

Growth-restricted preterm infants show no early inflammation. By day 14, however, they have higher levels of key inflammatory proteins, indicating a delayed inflammatory response.

Area of Science:

  • Neonatal Medicine
  • Immunology
  • Perinatal Research

Background:

  • Infants born before 28 weeks gestation are at risk for complications.
  • Systemic inflammation is a concern in preterm infants.

Purpose of the Study:

  • Compare early postnatal systemic inflammation patterns.
  • Investigate inflammation in growth-restricted preterm infants versus peers.

Main Methods:

  • Measured 25 inflammation-related proteins in blood spots from 939 newborns.
  • Analyzed samples collected within the first 2 postnatal weeks.
  • Calculated odds ratios for protein concentrations in the highest quartile.

Main Results:

  • No increased risk of early systemic inflammation in severely growth-restricted infants (Z-score <-2).
  • On postnatal day 14, these infants showed significantly higher concentrations of CRP, IL-1β, IL-6, TNF-α, IL-8, MCP-4, ICAM-1, ICAM-3, E-SEL, MMP-9, VEGF-R2, and IGFBP-1.
  • Increased risks were independent of delivery indication, bacteremia, or ventilation duration.

Conclusions:

  • Growth-restricted preterm newborns exhibit an elevated risk of increased inflammation-associated protein concentrations by postnatal day 14.
  • This suggests a delayed but significant inflammatory response in this vulnerable population.
Abstract

Keywords:
Growth-restrictedIUGRInflammationNeonatePreterm

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