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Updated: Sep 25, 2025

Transcutaneous Microcirculatory Imaging in Preterm Neonates
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Umbilical Cord and Neonatal Transthyretin and Their Relationship to Growth and Nutrition in Preterm Infants

Clair Habib1,2,3, Irit Maor2,4, Irit Shoris3

  • 1Genetics Institute and Pediatric Metabolic Unit, Rambam Health Care Campus, Haifa, Israel.

Rambam Maimonides Medical Journal
|April 28, 2022
PubMed

Insights

Transthyretin (TTR) levels in preterm infants increase with age but do not correlate with nutritional status. Umbilical cord TTR is not an indicator of intrauterine growth or maturity.

Area of Science:

  • Neonatal Medicine
  • Biochemistry
  • Nutritional Science

Background:

  • Transthyretin (TTR), also known as prealbumin, is a protein that has been investigated as a potential marker for nutritional status.
  • Understanding TTR dynamics in neonates is crucial for assessing their health and development.

Purpose of the Study:

  • To investigate the relationship between maternal and umbilical cord (UC) TTR and intrauterine growth.
  • To examine serum TTR in preterm infants concerning their nutritional status and growth during the neonatal period.

Main Methods:

  • A cohort of 49 preterm infants (mean gestational age 32.9 weeks) was studied.
  • TTR levels were measured at birth, day 14, day 28, and at discharge.
  • Growth parameters and nutritional laboratory tests were analyzed alongside TTR levels.

Main Results:

  • Maternal and UC TTR showed a positive correlation, but UC TTR did not predict maturity or intrauterine growth.
  • UC TTR was higher in female infants, and maternal TTR was lower in twin pregnancies.
  • While TTR levels increased with post-menstrual and chronological age, no significant correlation was found with weight gain or nutritional markers, except for glucose and triglycerides.

Conclusions:

  • Serum TTR levels in preterm infants increase over time during the neonatal course.
  • Significant correlations between TTR and established nutritional status indicators were not demonstrated in this study.
  • TTR may not be a reliable sole indicator of nutritional status in preterm neonates.
Abstract

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