Systemic Inflammation in the First 2 Weeks after Birth as a Determinant of Physical Growth Outcomes in Hospitalized Infants with Extremely Low Gestational Age - 21/12/21
, Sara E. Ramel, MD 3, Camilia R. Martin, MD, MS 2, 4, Raina Fichorova, MD, PhD 2, 5, Karl C.K. Kuban, MD, SM 6, Timothy Heeren, PhD 6, Rebecca C. Fry, PhD 7, T. Michael O'Shea, MD, MPH 8Abstract |
Objective |
To examine associations of systemic inflammation with growth outcomes at neonatal intensive care unit discharge or transfer among infants with extremely low gestational ages.
Study design |
We studied 850 infants at born at 23-27 weeks of gestation. We defined inflammatory protein elevation as the highest quartile of C-reactive protein (CRP), Interleukin (IL)-6, tumor necrosis factor-∝, or IL-8 on postnatal days 1, 7, and 14. We compared z-scores of weight, length, and head circumference at neonatal intensive care unit discharge or transfer between infants with vs without inflammatory protein elevation, adjusting in linear regression for birth size z-score, sex, gestational age, diet, comorbidities, medications, and length of hospitalization.
Results |
The mean gestational age was 25 weeks (range, 23-27 weeks) and birth weight z-score 0.14 (range, −2.73 to 3.28). Infants with a high CRP on day 7 had lower weights at discharge or transfer (−0.17 z-score; 95% CI, −0.27 to −0.06) than infants without CRP elevation, with similar results on day 14. Infants with CRP elevation on day 14 were also shorter (−0.21 length z-scores; 95% CI, −0.38 to −0.04), and had smaller head circumferences (−0.18 z-scores; 95% CI, −0.33 to −0.04) at discharge or transfer. IL-6 elevation on day 14 was associated with lower weight (−0.12; 95% CI, −0.22 to −0.02); IL-6 elevation on day 7 was associated with shorter length (−0.27; 95% CI, −0.43 to −0.12). Tumor necrosis factor-∝ and IL-8 elevation on day 14 were associated with a lower weight at discharge or transfer.
Conclusions |
Postnatal systemic inflammation may contribute to impaired nutrient accretion during a critical period in development in infants with extremely low gestational ages.
Le texte complet de cet article est disponible en PDF.Keywords : inflammation, growth, preterm infant, epidemiology
Abbreviations : ELGAN, CRP, IL, TNF-α, IGF-1, NICU
Plan
| Supported by the National Institutes of Health (NIH), National Institute of Neurological Disorders and Stroke (U01 NS040069, R01 NS040069), the Office of the NIH Director (UH3 OD023348), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01 HD092374). The authors declare no conflicts of interest. |
Vol 240
P. 37 - janvier 2022 Retour au numéro
Article précédent
- Low Rate of Spontaneous Closure in Premature Infants Discharged with a Patent Ductus Arteriosus: A Multicenter Prospective Study
- Veeral N. Tolia, George C. Powers, Amy S. Kelleher, M. Whit Walker, Kristy K. Herrman, Kaashif A. Ahmad, Basharat Buchh, Matthew C. Egalka, Michael Hinkes, Meiyun Ma, Moira Richards, Anthony C. Rudine, Ray Y. Sato, Kenneth M. Shaffer, Reese H. Clark
- Adverse Events and Associated Factors During Intrahospital Transport of Newborn Infants
- Romaine Delacrétaz, Céline J. Fischer Fumeaux, Corinne Stadelmann, Adriana Rodriguez Trejo, Alice Destaillats, Eric Giannoni
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?