Eduardo Cuestas1, Belén Aguilera2, Manuel Cerutti2, Alina Rizzotti3. 1. Department of Pediatrics and Neonatology, Hospital Privado Universitario de Córdoba, Córdoba, Argentina; Department of Pediatrics, Instituto Universitario de Ciencias Biomédicas de Córdoba, Córdoba, Argentina. Electronic address: ecuestas@hospitalprivadosa.com.ar. 2. Department of Pediatrics and Neonatology, Hospital Privado Universitario de Córdoba, Córdoba, Argentina. 3. Department of Pediatrics and Neonatology, Hospital Privado Universitario de Córdoba, Córdoba, Argentina; Department of Pediatrics, Instituto Universitario de Ciencias Biomédicas de Córdoba, Córdoba, Argentina.
Abstract
OBJECTIVE: To determine whether a sustained neonatal systemic inflammatory response was associated with poor postnatal growth among infants born very preterm during the first year of life. STUDY DESIGN: We studied prospectively 192 infants born preterm (birth weight ≤1.5 kg and gestational age ≤31 weeks). Weight, length, and head circumference were measured at birth, term, 4, and 12 months of corrected age. Serial C-reactive protein and procalcitonin were measured at 1, 3, 7, 14, and 28 days of age and averaged for each infant. A sustained neonatal systemic inflammatory response was defined as an average C-reactive protein level greater than the median for the group. Analysis was undertaken with linear mixed models. RESULTS: Decreases in mean z scores for weight, length, and head circumference were associated with the presence of a sustained neonatal systemic inflammatory response from birth to 12 months of corrected age (β [95% CI] = -0.282 [-0.306 to -0.258]; -1.899 [-2.028,-1.769]; -0.806 [-0.910, to -0.701], P < .001, respectively) in main effect models. This association remained significant after including interaction terms for bronchopulmonary dysplasia, neonatal sepsis, and necrotizing enterocolitis (β [95% CI] = -0.393 [-0.520 to -0.265]; -2.128 [-2.754, -1.503]; -1.102 [-1.604, -0.600]; P < .001; respectively) in interaction models. CONCLUSIONS: A sustained neonatal systemic inflammatory response was associated with poor postnatal growth, particularly poor linear growth. Serial C-reactive protein and procalcitonin may be useful markers for identifying infants at risk for postnatal growth failure.
OBJECTIVE: To determine whether a sustained neonatal systemic inflammatory response was associated with poor postnatal growth among infants born very preterm during the first year of life. STUDY DESIGN: We studied prospectively 192 infants born preterm (birth weight ≤1.5 kg and gestational age ≤31 weeks). Weight, length, and head circumference were measured at birth, term, 4, and 12 months of corrected age. Serial C-reactive protein and procalcitonin were measured at 1, 3, 7, 14, and 28 days of age and averaged for each infant. A sustained neonatal systemic inflammatory response was defined as an average C-reactive protein level greater than the median for the group. Analysis was undertaken with linear mixed models. RESULTS: Decreases in mean z scores for weight, length, and head circumference were associated with the presence of a sustained neonatal systemic inflammatory response from birth to 12 months of corrected age (β [95% CI] = -0.282 [-0.306 to -0.258]; -1.899 [-2.028,-1.769]; -0.806 [-0.910, to -0.701], P < .001, respectively) in main effect models. This association remained significant after including interaction terms for bronchopulmonary dysplasia, neonatal sepsis, and necrotizing enterocolitis (β [95% CI] = -0.393 [-0.520 to -0.265]; -2.128 [-2.754, -1.503]; -1.102 [-1.604, -0.600]; P < .001; respectively) in interaction models. CONCLUSIONS: A sustained neonatal systemic inflammatory response was associated with poor postnatal growth, particularly poor linear growth. Serial C-reactive protein and procalcitonin may be useful markers for identifying infants at risk for postnatal growth failure.
Authors: Mandy B Belfort; Sara E Ramel; Camilia R Martin; Raina Fichorova; Karl C K Kuban; Timothy Heeren; Rebecca C Fry; T Michael O'Shea Journal: J Pediatr Date: 2021-09-08 Impact factor: 4.406
Authors: Stephen Wedgwood; Kimberly Gerard; Katrina Halloran; Ashley Hanhauser; Sveva Monacelli; Cris Warford; Phung N Thai; Nipavan Chiamvimonvat; Satyan Lakshminrusimha; Robin H Steinhorn; Mark A Underwood Journal: Front Immunol Date: 2020-03-05 Impact factor: 7.561