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Published on: August 24, 2011
Metabolic biomarkers of small and large for gestational age newborns
Aviv Schupper1, Shlomo Almashanu2, Dan Coster3
1Department of Pediatrics, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
Small for gestational age (SGA) and large for gestational age (LGA) newborns exhibit distinct metabolic profiles. SGA infants showed elevated levels of certain amino acids and carnitine, while LGA infants had decreased levels of others.
Area of Science:
- Neonatal metabolic health
- Biomarker discovery in newborns
- Perinatal medicine
Background:
- Newborns who are small for gestational age (SGA) or large for gestational age (LGA) face increased risks for developmental, metabolic, and cardiovascular issues.
- Understanding the metabolic differences in these groups is crucial for addressing associated morbidities.
Purpose of the Study:
- To compare metabolic biomarkers in SGA and LGA newborns against appropriate for gestational age (AGA) newborns.
- To investigate potential pathogenic pathways contributing to morbidities in SGA and LGA infants.
Main Methods:
- Observational retrospective study of 70,809 term newborns.
- Categorization into AGA, SGA, LGA, and severe subcategories (<3rd or ≥97th percentile).
- Measurement of 18 metabolites using dried blood tandem mass spectrometry, with univariate and multivariate logistic regression analysis.
Main Results:
- SGA newborns showed significantly elevated methionine, proline, free carnitine, and reduced valine compared to AGA (P < .0001).
- Severe SGA exhibited more pronounced trends, including elevated leucine.
- LGA newborns displayed significantly lower citrulline, glutamine, proline, tyrosine, and elevated leucine (P ≤ .0033).
Conclusions:
- SGA and LGA newborns present distinct metabolic biomarker patterns in newborn screening.
- Metabolite alterations in SGA were predominantly elevated, whereas in LGA, they were decreased compared to AGA.
- Further trials are needed to determine if these metabolic changes predict or are involved in long-term outcomes.
Background:
Small for gestational age (SGA) and large for gestational age (LGA) newborns are at increased risk for developmental, metabolic and cardiovascular morbidities.
Aims:
To compare the metabolic biomarkers of SGA and LGA infants with those of appropriate for gestational age (AGA) newborns in order to shed more light on a possible pathogenesis of those morbidities.
Study Design:
An observational retrospective study.
Subjects:
70,809 term newborns divided into AGA, SGA, LGA, and severe subcategories (<3rd percentile or ≥97th percentile).
Outcome Measures:
18 metabolites were measured by dried blood tandem mass spectrometry and compared in between groups in univariate and multivariate logistic regression.
Results:
SGA newborns had a significant likelihood for elevated methionine, proline, free carnitine, and reduced valine levels compared to AGA newborns (P < .0001). Severe SGA showed more apparent trends including elevated leucine. LGA newborns had a significant likelihood for low citrulline, glutamine, proline, tyrosine, and elevated leucine levels (P ≤ .0033). Severe LGA newborns showed the same trends, with the exception of citrulline and glutamine.
Conclusions:
SGA and LGA newborns demonstrate distinct metabolic biomarkers in newborn screening. Most of the altered metabolites in the SGA group were elevated while those in the LGA group were decreased in comparison to AGA newborns. These trends were more apparent in the severe SGA subgroup while they mostly remained the same in the severe LGA subgroup. Whether these metabolic changes are involved with or can predict long-term outcome awaits further trials.
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