Steven W Graves1, Michael S Esplin2, Paula McGee3, Dwight J Rouse4, Kenneth J Leveno5, Brian M Mercer6, Jay D Iams7, Ronald J Wapner8, Yoram Sorokin9, John M Thorp10, Susan M Ramin11, Fergal D Malone12, Mary J O'Sullivan13, Alan M Peaceman14, Gary D V Hankins15, Donald J Dudley16, Steven N Caritis17. 1. Department of Chemistry and Biochemistry, Brigham Young University, Provo, UT. Electronic address: swgraves@chem.byu.edu. 2. Departments of Obstetrics and Gynecology, Utah Health Science Center, Salt Lake City, UT. 3. Biostatistics Center, George Washington University, Washington, DC. 4. University of Alabama at Birmingham School of Medicine, Birmingham, AL. 5. University of Texas Southwestern Medical Center, Dallas, TX. 6. Case Western Reserve University-MetroHealth Medical Center, Cleveland, OH, and University of Tennessee, Memphis, TN. 7. The Ohio State University College of Medicine, Columbus, OH. 8. Jefferson Medical College, Thomas Jefferson University, and Drexel University College of Medicine, Philadelphia, PA. 9. Wayne State University School of Medicine, Detroit, MI. 10. University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC. 11. University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, TX. 12. College of Physicians and Surgeons, Columbia University, New York, NY. 13. Miller School of Medicine, University of Miami, Miami, FL. 14. Feinberg School of Medicine, Northwestern University, Chicago, IL. 15. University of Texas Medical Branch, Galveston, TX. 16. University of Texas at San Antonio School of Medicine, San Antonio, TX. 17. University of Pittsburgh School of Medicine, Pittsburgh, PA.
Abstract
OBJECTIVE: Endogenous digoxin-like factor (EDLF) has been linked to vasoconstriction, altered membrane transport, and apoptosis. Our objective was to determine whether increased EDLF in the cord sera of preterm infants was associated with an increased incidence of necrotizing enterocolitis (NEC). STUDY DESIGN: Cord sera from pregnant women enrolled in a randomized trial of MgSO4 for fetal neuroprotection were analyzed for EDLF using a red cell Rb(+) uptake assay in which the inhibition of sodium pump-mediated Rb(+) transport was used as a functional assay of EDLF. Specimens were assayed blinded to neonatal outcome. Cases (NEC, n = 25) and controls (neonates not developing stage 2 or 3 NEC, n = 24) were matched by study center and gestational age. None of the women had preeclampsia. Cases and controls were compared using the Wilcoxon test for continuous and the Fisher exact test for categorical variables. A conditional logistic regression analysis was used to assess the odds of case vs control by EDLF level. RESULTS: Cases and controls were not significantly different for gestational age, race, maternal steroid use, premature rupture of membranes, or MgSO4 treatment. In logistic models adjusted for treatment group, race, premature rupture of membranes, and gestational age, cord sera EDLF was significantly associated with development of NEC (P = .023). CONCLUSION: These data demonstrated an association between cord sera EDLF and NEC.
OBJECTIVE: Endogenous digoxin-like factor (EDLF) has been linked to vasoconstriction, altered membrane transport, and apoptosis. Our objective was to determine whether increased EDLF in the cord sera of preterm infants was associated with an increased incidence of necrotizing enterocolitis (NEC). STUDY DESIGN: Cord sera from pregnant women enrolled in a randomized trial of MgSO4 for fetal neuroprotection were analyzed for EDLF using a red cell Rb(+) uptake assay in which the inhibition of sodium pump-mediated Rb(+) transport was used as a functional assay of EDLF. Specimens were assayed blinded to neonatal outcome. Cases (NEC, n = 25) and controls (neonates not developing stage 2 or 3 NEC, n = 24) were matched by study center and gestational age. None of the women had preeclampsia. Cases and controls were compared using the Wilcoxon test for continuous and the Fisher exact test for categorical variables. A conditional logistic regression analysis was used to assess the odds of case vs control by EDLF level. RESULTS: Cases and controls were not significantly different for gestational age, race, maternal steroid use, premature rupture of membranes, or MgSO4 treatment. In logistic models adjusted for treatment group, race, premature rupture of membranes, and gestational age, cord sera EDLF was significantly associated with development of NEC (P = .023). CONCLUSION: These data demonstrated an association between cord sera EDLF and NEC.
Authors: Ronnie Guillet; Barbara J Stoll; C Michael Cotten; Marie Gantz; Scott McDonald; W Kenneth Poole; Dale L Phelps Journal: Pediatrics Date: 2006-01-03 Impact factor: 7.124
Authors: Garrett K Lam; Moana Hopoate-Sitake; C David Adair; Vardaman M Buckalew; Donna D Johnson; David F Lewis; Christopher J Robinson; George R Saade; Steven W Graves Journal: Am J Obstet Gynecol Date: 2013-04-10 Impact factor: 8.661