Systemic Inflammation in the First 2 Weeks after Birth as a Determinant of Physical Growth Outcomes in Hospitalized Infants with Extremely Low Gestational Age

被引:6
|
作者
Belfort, Mandy B. [1 ,2 ]
Ramel, Sara E. [3 ]
Martin, Camilia R. [2 ,4 ]
Fichorova, Raina [2 ,5 ]
Kuban, Karl C. K. [6 ]
Heeren, Timothy [6 ]
Fry, Rebecca C. [7 ]
O'Shea, T. Michael [8 ]
机构
[1] Brigham & Womens Hosp, Dept Pediat Newborn Med, 221 Longwood Ave BL 341, Boston, MA 02115 USA
[2] Harvard Med Sch, Boston, MA 02115 USA
[3] Univ Minnesota, Sch Med, Minneapolis, MN 55455 USA
[4] Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA
[5] Brigham & Womens Hosp, Dept Obstet & Gynecol, 75 Francis St, Boston, MA 02115 USA
[6] Boston Univ, Sch Med, Boston, MA 02118 USA
[7] Univ N Carolina, Dept Environm Sci & Engn, Sch Med, Chapel Hill, NC 27515 USA
[8] Univ N Carolina, Div Neonatal Perinatal Med, Sch Med, Chapel Hill, NC 27515 USA
来源
JOURNAL OF PEDIATRICS | 2022年 / 240卷
基金
美国国家卫生研究院;
关键词
LINEAR GROWTH; CHILDREN BORN; COGNITIVE IMPAIRMENT; PROTEINS; FAILURE; RISK; NEURODEVELOPMENT; INTERLEUKIN-6; INFECTION; VELOCITY;
D O I
10.1016/j.jpeds.2021.09.006
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
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-proportional to, 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-proportional to 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.
引用
收藏
页码:37 / +
页数:8
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