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Intermittent Hypoxemia in Preterm Infants: A Potential Proinflammatory Process

Elie G Abu Jawdeh1, Hong Huang1, Philip M Westgate2

  • 1Division of Neonatology, Department of Pediatrics, College of Medicine, University of Kentucky, Lexington, Kentucky.

American Journal of Perinatology
|June 9, 2020
PubMed

Insights

Intermittent hypoxemia (IH) is common in preterm infants and linked to higher C-reactive protein (CRP) levels, indicating systemic inflammation. Longer IH events, especially those exceeding one minute, are significantly associated with increased CRP.

Area of Science:

  • Neonatal Medicine
  • Pediatric Inflammation
  • Respiratory Physiology

Background:

  • Intermittent hypoxemia (IH) is a frequent complication in preterm infants.
  • Existing research in adults and animal models suggests IH is proinflammatory.
  • Data on IH and systemic inflammation in preterm infants is limited.

Purpose of the Study:

  • To investigate the association between intermittent hypoxemia (IH) and systemic inflammation, specifically serum C-reactive protein (CRP).
  • To determine if IH is a proinflammatory factor in preterm infants.

Main Methods:

  • Serum CRP levels were measured in 26 preterm infants at 30 days of life.
  • IH metrics (frequency, duration, percentage of time in hypoxemia) were assessed the week prior to CRP collection.
  • Spearman's correlation was used to analyze the relationship between IH measures and CRP levels.

Main Results:

  • Positive correlations were observed between IH measures and serum CRP levels.
  • The association was particularly strong for IH events longer than 1 minute (r range: 0.56-0.74, p < 0.01).
  • The findings indicate a link between IH and elevated CRP in this cohort.

Conclusions:

  • This study provides the first evidence in preterm infants that intermittent hypoxemia (IH) is associated with increased C-reactive protein (CRP).
  • The results support the hypothesis that IH acts as a proinflammatory process in preterm neonates.
  • Longer duration IH events (>1 minute) appear to be the most significant contributors to this inflammatory response.
Abstract

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