Perinatal systemic inflammatory responses of growth-restricted preterm newborns

McElrath, Thomas F.; Allred, Elizabeth N.; Marter, Linda Van; Fichorova, RN; Leviton, Alan; Investigators, Elgan Study

doi:10.1111/apa.12339

Cited by 68 publications

(92 citation statements)

References 22 publications

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“…Previous studies also revealed an association between inflammation and fetal growth restriction [19,20]. Increased serum inflammatory markers were detected in growth restricted infants on postnatal day 14 [21]. Furthermore, Hill et al found higher concentrations of renin and lower concentrations of leptin in neonates with IUGR accompanied by antenatal abnormal umbilical artery Doppler waveforms [unpublished raw data].…”

Section: Discussionmentioning

confidence: 96%

Maternal serum ferritin as a clinical tool at 34–36 weeks’ gestation for distinguishing subgroups of fetal growth restriction

Akkurt

Altay

et al. 2016

The Journal of Maternal-Fetal & Neonatal Medicine

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Section: Discussionmentioning

confidence: 96%

Maternal serum ferritin as a clinical tool at 34–36 weeks’ gestation for distinguishing subgroups of fetal growth restriction

Akkurt

Altay

et al. 2016

The Journal of Maternal-Fetal & Neonatal Medicine

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“…Higher rates of significant patent ductus arteriosus within 48 hours of birth have been observed among growth-restricted preterm infants of 26–32 weeks in comparison to non-growth-restricted infants (65% vs 40%) [11]. In addition, growth restricted infants have higher concentrations of some inflammation-related proteins, which might affect their response to pharmacologic PDA treatment [30]. …”

Section: Discussionmentioning

confidence: 99%

Efficacy of pharmacologic closure of patent ductus arteriosus in small-for-gestational-age extremely preterm infants

Boghossian

Tiddi

Bell

et al. 2017

Early Human Development

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Background Optimal management of the patent ductus arteriosus (PDA) in preterm infants remains controversial. Therefore, studies identifying infants who are most likely to benefit from PDA treatment are needed. Aim We sought to examine if significant intrauterine growth restriction, defined by birth weight z-score, reduces the efficacy of PDA closure with indomethacin or ibuprofen and thereby increases the need for surgical closure of PDA after pharmacologic treatment. Study design, subjects, and outcome measures We studied infants 23–28 weeks’ gestation born 2006–2013 at NICHD Neonatal Research Network centers. We examined the responses to PDA treatment with indomethacin and/or ibuprofen and whether the PDA was subsequently closed surgically. Logistic regression generated adjusted odds ratios (ORs) for the associations between the z-score groups (<−2, −2 to −0.5, and >−0.5) and PDA surgery following pharmacologic treatment. Results 5,606 infants were diagnosed with PDA; 3,587 (64.0%) received indomethacin or ibuprofen or both, and 909 (25.3%) underwent PDA surgery. Mothers of infants with PDA non-closure were less likely to have hypertension (19% vs. 28%). Infants with non-closure were more likely to be female (53% vs. 49%), have lower gestational age and birth weight and to develop sepsis (42% vs. 31%). Compared to infants with z-score >−0.5, PDA surgery was increased among infants with z-score −2 to −0.5 (OR=1.23; 95% CI 1.02–1.47) but not among infants with z-score <−2. Conclusion Infants with birth weight z-score −2 to −0.5 are more likely than normally grown infants to require PDA surgery following pharmacologic treatment.

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“…Systemic inflammation is recognized as another risk factor for CLD and a recent report demonstrates that growth-restricted preterm newborns are at increased risk for postnatal elevated concentrations of inflammation-associated proteins [19]. Fetal growth restriction impact on lung development and postnatal systemic inflammation might be two synergistic factors leading to the risk of CLD.…”

Section: Discussionmentioning

confidence: 99%

Fetal Growth Restriction Is Worse than Extreme Prematurity for the Developing Lung

et al. 2014

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Background: Perinatal lung growth is highly vulnerable to inflammation and intrauterine growth restriction (IUGR), two major risk factors for chronic lung disease (CLD) in preterm neonates. However, the balance between extremely low gestational age (ELGA) and IUGR in very preterm infants as risk factors for CLD and co-morbidities remains poorly explored. Objectives: This single-center study aims to compare neonatal morbidity (including CLD) and mortality among ELGA infants with normal birth weight (ELGA-AGA), very preterm infants with IUGR <3rd percentile (VLGA-IUGR) and very preterm infants with a birth weight appropriate for gestational age (VLGA-AGA), matched with VLGA-IUGR infants. Methods: Selected characteristics of the perinatal and neonatal periods were recorded and retrospectively compared among the three groups. Infants with major congenital anomalies were excluded. The diagnosis of CLD was based on whether the infant was receiving supplemental oxygen and/or non-invasive ventilation at a postmenstrual age of 36 weeks. Results: We found that, despite a median difference of 3 weeks in gestational age at birth between VLGA-IUGR and ELGA-AGA infants, neonatal mortality was 35% higher in neonates who had experienced fetal growth restriction, and that VLGA- IUGR was five times more predictive of CLD than was ELGA-AGA. These differences persisted after adjustment for confounding factors such as antenatal steroids, gender and respiratory distress syndrome. Conclusions: This study reports that VLGA-IUGR infants are at higher risk of neonatal mortality and CLD than both ELGA-AGA and VLGA-AGA infants.

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Perinatal systemic inflammatory responses of growth-restricted preterm newborns

Cited by 68 publications

References 22 publications

Maternal serum ferritin as a clinical tool at 34–36 weeks’ gestation for distinguishing subgroups of fetal growth restriction

Maternal serum ferritin as a clinical tool at 34–36 weeks’ gestation for distinguishing subgroups of fetal growth restriction

Efficacy of pharmacologic closure of patent ductus arteriosus in small-for-gestational-age extremely preterm infants

Fetal Growth Restriction Is Worse than Extreme Prematurity for the Developing Lung

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