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Diagnostic value of laboratory markers of enteric dysfunction in preterm infants
1BUKOVINIAN STATE MEDICAL UNIVERSITY, CHERNIVTSI, UKRAINE.
Insights
This study identifies key clinical and laboratory markers for diagnosing food intolerance in premature infants. Early detection using these indicators can improve diagnostic accuracy in neonatal care.
Area of Science:
- Neonatology
- Pediatric Gastroenterology
- Perinatal Medicine
Background:
- Food tolerance disorders are common in preterm infants.
- Perinatal pathology and gestational age influence these disorders.
- Accurate diagnosis is crucial for effective management.
Purpose of the Study:
- To investigate specific clinical and laboratory features of food intolerance in preterm infants.
- To identify risk factors including gestational age and maternal labor.
- To establish pathogenetically sound diagnostic criteria.
Main Methods:
- Clinical and laboratory evaluation of 67 preterm infants (32-33/6 weeks gestation) with food intolerance.
- Comparison with 31 healthy newborns (34-37 weeks gestation).
- Analysis of coprofiltrate parameters: albumin, alpha-1-antitrypsin, elastase, PMN elastase, and calprotectin.
Main Results:
- Clinical signs included regurgitation, stasis, intestinal paresis, and abnormal stool (e.g., bile, blood).
- Pain syndromes correlated with apnea, bradycardia, and decreased blood saturation.
- Key laboratory markers identified: elevated calprotectin (>390.15 μg/g), albumin (>37.25 μg/g), α-1-antitrypsin (>452.67 μg/g), and decreased PMN elastase (<95.49 ng/g).
Conclusions:
- Clinical signs combined with specific laboratory markers enhance food intolerance diagnosis in preterm infants.
- Implementing these markers improves diagnostic effectiveness in perinatal pathology.
- Recommendations for using these parameters in neonatology are supported by the findings.
Objective:
Aim: To study the peculiarities of food tolerance disorders in premature infants, taking into account the risk factors of gestational age and maternal labor, the peculiarities of the course of perinatal pathology, in order to determine pathogenetically sound clinical and laboratory criteria.
Patients And Methods:
Materials and Methods: A comprehensive clinical and laboratory evaluation was performed on 67 preterm infants of gestational age 32 to 33/6 weeks with severe food tolerance disorders in perinatal pathology. The comparison group consisted of 31 newborns with gestational age of 34 to 37 weeks. In addition to standard laboratory tests, coprofiltrate parameters (albumin, alpha-1-antitrypsin, elastase, PMN elastase, calprotectin) were examined.
Results:
Results: The clinical signs of food intolerance included regurgitation and stasis (86,57%), intestinal paresis with delayed meconium and transitional stool (70,15%), flatulence (47,76%), bile or blood impurities in the stool (43,28%). The presence of pain syndromes in conjunction with eating dysfunction was accompanied by episodes of apnea, bradycardia, and decreased blood saturation. The laboratory markers of intestinal dysfunction were the following: increased levels of calprotectin > 390,15 μg/g; albumin > 37,25 μg/g; α-1-antitrypsin > 452,67 μg/g; decreased levels of PMN elastase <95,49 ng/g. The representativeness of these clinical and paraclinical parameters was investigated, which gave grounds to recommend their use in clinical practice in neonatology.
Conclusion:
Conclusions: The implementation of recommendations for the use of laboratory markers of food intolerance, along with clinical signs, will increase the effectiveness of diagnostic measures in perinatal pathology in preterm infants.
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