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Updated: May 3, 2026

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Complement profile in neonates of different gestational ages.

A S Grumach1, M E Ceccon, R Rutz

  • 1Department of Dermatology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; Faculty of Medicine ABC, Outpatient Clinic of Recurrent Infections, São Paulo, Brazil.

Scandinavian Journal of Immunology
|January 28, 2014
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Summary

The complement system in preterm infants shows relative immaturity, particularly in regulatory proteins. This developmental stage may impact their susceptibility to infections, highlighting the need for further research.

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Area of Science:

  • Neonatal immunology
  • Innate immunity
  • Complement system biology

Background:

  • Limited data exists on complement system regulators in preterm infants.
  • Understanding complement development is crucial for assessing infection risk in neonates.

Purpose of the Study:

  • To establish a complement profile in premature and term neonates.
  • To investigate blood levels of mannan-binding lectin (MBL) and regulatory proteins.
  • To assess classical pathway activity for estimating infection susceptibility.

Main Methods:

  • Assessed complement activity (CH50), MBL levels, complement regulators (factors H and I, C1 inhibitor, properdin), and C3a in three newborn groups (preterm, late preterm, term).
  • Compared cord blood and day 5 post-delivery venous blood.
  • Analyzed C3a levels to rule out activation-induced consumption.

Main Results:

  • Complement activity (CH50) increased with gestational age, with lower levels in cord blood than day 5.
  • Mannan-binding lectin (MBL) concentrations did not differ significantly between groups.
  • C1 inhibitor levels were below adult ranges in preterm infants (<34 weeks) and lower in cord blood.
  • Factors I, H, and properdin remained below adult values across all groups.
  • Low C3a levels indicated that low complement titres were not due to activation-induced consumption.

Conclusions:

  • The complement system and its regulation are relatively immature in neonates, especially in preterm infants.
  • This immaturity may influence the immune defense capabilities of preterm newborns.
  • Further studies are warranted to explore the clinical implications of complement system development in neonates.