Karl G Sylvester1, Zachary J Kastenberg2, R Larry Moss3, Gregory M Enns4, Tina M Cowan5, Gary M Shaw4, David K Stevenson4, Tiffany J Sinclair6, Curt Scharfe7, Kelli K Ryckman8, Laura L Jelliffe-Pawlowski9. 1. Department of Surgery, Stanford University School of Medicine, Stanford, CA; Center for Fetal and Maternal Health, Lucile Packard Children's Hospital, Stanford, CA. Electronic address: Sylvester@Stanford.edu. 2. Department of Surgery, Stanford University School of Medicine, Stanford, CA; Center for Health Policy/Center for Primary Care and Outcomes Research, Stanford University/Stanford University School of Medicine, Stanford, CA. 3. Pediatric Surgery, Nationwide Children's Hospital, Ohio State University School of Medicine, Columbus, OH. 4. Department of Pediatrics, Stanford University School of Medicine, Stanford, CA. 5. Department of Pathology, Stanford University School of Medicine, Stanford, CA. 6. Department of Surgery, Stanford University School of Medicine, Stanford, CA. 7. Stanford Genome Technology Center, Stanford University, Palo Alto, CA. 8. Departments of Epidemiology and Pediatrics, College of Public Health and Carver College of Medicine, University of Iowa, Iowa, IA. 9. Department of Epidemiology and Biostatistics, Division of Preventive Medicine and Public Health, University of California San Francisco School of Medicine, San Francisco, CA.
Abstract
OBJECTIVE: To evaluate the association between newborn acylcarnitine profiles and the subsequent development of necrotizing enterocolitis (NEC) with the use of routinely collected newborn screening data in infants born preterm. STUDY DESIGN: A retrospective cohort study was conducted with the use of discharge records for infants born preterm admitted to neonatal intensive care units in California from 2005 to 2009 who had linked state newborn screening results. A model-development cohort of 94 110 preterm births from 2005 to 2008 was used to develop a risk-stratification model that was then applied to a validation cohort of 22 992 births from 2009. RESULTS: Fourteen acylcarnitine levels and acylcarnitine ratios were associated with increased risk of developing NEC. Each log unit increase in C5 and free carnitine /(C16 + 18:1) was associated with a 78% and a 76% increased risk for developing NEC, respectively (OR 1.78, 95% CI 1.53-2.02, and OR 1.76, 95% CI 1.51-2.06). Six acylcarnitine levels, along with birth weight and total parenteral nutrition, identified 89.8% of newborns with NEC in the model-development cohort (area under the curve 0.898, 95% CI 0.889-0.907) and 90.8% of the newborns with NEC in the validation cohort (area under the curve 0.908, 95% CI 0.901-0.930). CONCLUSIONS: Abnormal fatty acid metabolism was associated with prematurity and the development of NEC. Metabolic profiling through newborn screening may serve as an objective biologic surrogate of risk for the development of disease and thus facilitate disease-prevention strategies.
OBJECTIVE: To evaluate the association between newborn acylcarnitine profiles and the subsequent development of necrotizing enterocolitis (NEC) with the use of routinely collected newborn screening data in infants born preterm. STUDY DESIGN: A retrospective cohort study was conducted with the use of discharge records for infants born preterm admitted to neonatal intensive care units in California from 2005 to 2009 who had linked state newborn screening results. A model-development cohort of 94 110 preterm births from 2005 to 2008 was used to develop a risk-stratification model that was then applied to a validation cohort of 22 992 births from 2009. RESULTS: Fourteen acylcarnitine levels and acylcarnitine ratios were associated with increased risk of developing NEC. Each log unit increase in C5 and free carnitine /(C16 + 18:1) was associated with a 78% and a 76% increased risk for developing NEC, respectively (OR 1.78, 95% CI 1.53-2.02, and OR 1.76, 95% CI 1.51-2.06). Six acylcarnitine levels, along with birth weight and total parenteral nutrition, identified 89.8% of newborns with NEC in the model-development cohort (area under the curve 0.898, 95% CI 0.889-0.907) and 90.8% of the newborns with NEC in the validation cohort (area under the curve 0.908, 95% CI 0.901-0.930). CONCLUSIONS: Abnormal fatty acid metabolism was associated with prematurity and the development of NEC. Metabolic profiling through newborn screening may serve as an objective biologic surrogate of risk for the development of disease and thus facilitate disease-prevention strategies.
Authors: Natalie M Gallant; Karen Leydiker; Hao Tang; Lisa Feuchtbaum; Fred Lorey; Rebecca Puckett; Joshua L Deignan; Julie Neidich; Naghmeh Dorrani; Erica Chang; Bruce A Barshop; Stephen D Cederbaum; Jose E Abdenur; Raymond Y Wang Journal: Mol Genet Metab Date: 2012-02-09 Impact factor: 4.797
Authors: Lisa Feuchtbaum; Fred Lorey; Lisa Faulkner; John Sherwin; Robert Currier; Ajit Bhandal; George Cunningham Journal: Pediatrics Date: 2006-05 Impact factor: 7.124
Authors: Kumanan Wilson; Steven Hawken; Beth K Potter; Pranesh Chakraborty; Mark Walker; Robin Ducharme; Julian Little Journal: Am J Obstet Gynecol Date: 2015-10-28 Impact factor: 8.661
Authors: Barbara B Warner; Ann Ladd Ryan; Kimberly Seeger; Anthony C Leonard; Christopher R Erwin; Brad W Warner Journal: J Pediatr Date: 2007-04 Impact factor: 4.406
Authors: Susan R Hintz; Douglas E Kendrick; Barbara J Stoll; Betty R Vohr; Avroy A Fanaroff; Edward F Donovan; W Kenneth Poole; Martin L Blakely; Linda Wright; Rosemary Higgins Journal: Pediatrics Date: 2005-03 Impact factor: 7.124
Authors: R L Moss; L A Kalish; C Duggan; P Johnston; M L Brandt; J C Y Dunn; R A Ehrenkranz; T Jaksic; K Nobuhara; B J Simpson; M C McCarthy; K G Sylvester Journal: J Perinatol Date: 2008-09-11 Impact factor: 2.521
Authors: Susan E Jacobs; Jacinta M Tobin; Gillian F Opie; Susan Donath; Sepehr N Tabrizi; Marie Pirotta; Colin J Morley; Suzanne M Garland Journal: Pediatrics Date: 2013-11-18 Impact factor: 7.124
Authors: Sonia T Anand; Kelli K Ryckman; Rebecca J Baer; Mary E Charlton; Patrick J Breheny; William W Terry; Kord Kober; Scott Oltman; Elizabeth E Rogers; Laura L Jelliffe-Pawlowski; Elizabeth A Chrischilles Journal: J Matern Fetal Neonatal Med Date: 2021-05-12
Authors: Scott P Oltman; Elizabeth E Rogers; Rebecca J Baer; James G Anderson; Martina A Steurer; Matthew S Pantell; J Colin Partridge; Larry Rand; Kelli K Ryckman; Laura L Jelliffe-Pawlowski Journal: J Pediatr Date: 2018-04-13 Impact factor: 4.406
Authors: Tiffany J Sinclair; Chengyin Ye; Yunliang Chen; Dongyan Zhang; Tian Li; Xuefeng Bruce Ling; Harvey J Cohen; Gary M Shaw; David K Stevenson; Donald Chace; Reese H Clark; Karl G Sylvester Journal: Nutrients Date: 2020-04-30 Impact factor: 5.717