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Gestational age and age at sampling influence metabolic profiles in premature infants

Reese H Clark1, Amy S Kelleher2, Donald H Chace2

  • 1Pediatrix-Obstetrix Center for Research, Education and Quality, Sunrise, Florida reese_clark@pediatrix.com.

Pediatrics
|June 11, 2014
PubMed

Insights

Gestational and chronological age significantly impact amino acid and acylcarnitine profiles in premature infants. These findings are crucial for interpreting metabolic screening tests in this vulnerable population.

Area of Science:

  • Biochemistry
  • Neonatology
  • Metabolomics

Background:

  • Premature infants often have altered metabolic profiles due to immaturity.
  • Accurate interpretation of metabolic screening tests is vital for early diagnosis of inborn errors of metabolism.

Purpose of the Study:

  • To investigate how gestational age and chronological age affect amino acid and acylcarnitine profiles in premature infants.
  • To establish reference values for metabolic profiles in preterm neonates.

Main Methods:

  • Metabolic profiles, including 15 amino acids and 35 acylcarnitines, were analyzed in infants born between 23 and 31 weeks of gestation.
  • Samples were collected within 24 hours of birth and on approximately days 7, 28, and 42, or at discharge.
  • Standard newborn screening techniques were employed, with analysis conducted by a central laboratory.

Main Results:

  • Of 995 infants studied, 21.5% had abnormal metabolic profiles; none were diagnosed with inborn errors of metabolism.
  • Both gestational age and postbirth chronological age significantly influenced the metabolic profiles.
  • Infants born earlier (23-26 weeks gestation) had higher rates of abnormal profiles (29%) compared to those born later (29-31 weeks gestation, 17%). Abnormalities were most frequent on day 7 for the earliest gestations (21%).

Conclusions:

  • The study highlights the complexity of interpreting metabolic profiles in preterm infants due to immaturity.
  • The data provide essential reference values for understanding metabolism and improving screening for inborn errors of metabolism in preterm neonates.
Abstract

Keywords:
acylcarnitineamino acidsand nutritionnewborn screening

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