Vaginal birth is associated with a large release of copeptin that exceeds all values published so far, including those in critically ill adult patients with shock or brain injury. Thus, vaginal birth is arguably the most intense stressor in life.

IntroductIon: adrenomedullin (aDM) is one of the strongest endogenous vasodilating hormones. Its stable by-product midregional-proaDM (MR-proaDM) is an established indicator of systemic infection and cardiovascular compromise in adult patients. Methods: a prospective cross-sectional study was performed to investigate the perinatal factors affecting MR-proaDM plasma concentrations in 328 newborn infants with a gestational age (Ga) between 24 and 41 wk. results: Blood samples were obtained in 270 infants from umbilical veins (with additional 108 paired samples from umbilical arteries), and at 2-3 d of life in 183 infants. Paired venous and arterial umbilical cord MR-proaDM concentrations were closely related (spearman's rank order correlation coefficient (R s ) = 0.825, P < 0.001). MR-proaDM concentrations at birth and at 2-3 d were inversely related to Ga (R s = −0.403 and R s = −0.541, respectively) and birth weight (BW; R s = −0.421 and R s = −0.530, respectively; all P < 0.001). On stepwise regression analysis, clinical chorioamnionitis and umbilical arterial blood base excess retained a significant impact on MR-proaDM cord venous blood concentrations. at 2-3 d of life, histologic chorioamnionitis and Ga at delivery were significantly associated with MR-proaDM levels. dIscussIon: as compared with adults, MR-proaDM concentrations are elevated in neonates, especially those born very preterm. Immaturity and infection, which both feature low systemic vascular resistance, are related to increased MR-proaDM concentrations.

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3 (R=0.597, p< 0.001, n=38; R=0.462, p=0.009, n=31). TNF-alpha and IL-10 both correlated with free TF in cord samples (R=0.536, p=0.012, n=31, and R=0.610, p=0.003, n=22). No correlations were found between cytokines and F1+2.