Department of Obstetrics and Gynecology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Acta Paediatr. 2013 Oct;102(10):e439-42. doi: 10.1111/apa.12339. Epub 2013 Aug 5.
To compare the early post-natal pattern of systemic inflammation in growth-restricted infants born before the 28th week of gestation to that of appropriately grown peers.
We measured the concentrations of 25 inflammation-related proteins in blood spots collected from 939 newborns during the first 2 post-natal weeks. We calculated the odds ratios (99% confidence intervals) that concentrations would be in the highest quartile.
Severely growth-restricted infants (birth weight Z-score <-2) were not at increased risk of systemic inflammation shortly after birth. On post-natal day 14, however, they were significantly more likely than their peers to have a CRP, IL-1β, IL-6, TNF-α, IL-8, MCP-4, ICAM-1, ICAM-3, E-SEL, MMP-9, VEGF-R2 and/or IGFBP-1 concentration in the highest quartile. These increased risks could not be attributed to delivery indication, bacteremia or duration of ventilation.
Growth-restricted preterm newborns appear to be at increased risk of elevated concentrations of inflammation-associated proteins by post-natal day 14.
比较胎龄<28 周生长受限儿与适于胎龄儿出生后早期系统性炎症的差异。
我们检测了 939 例新生儿在出生后前 2 周的血斑中 25 种炎症相关蛋白的浓度。我们计算了浓度处于最高四分位数的比值比(99%置信区间)。
严重生长受限儿(出生体重 Z 评分<-2)出生后短期内并未处于系统性炎症风险增加的状态。然而,在生后第 14 天,与对照组相比,其 C 反应蛋白(CRP)、白介素-1β(IL-1β)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白介素-8(IL-8)、单核细胞趋化蛋白-4(MCP-4)、细胞间黏附分子-1(ICAM-1)、细胞间黏附分子-3(ICAM-3)、E-选择素(E-SEL)、基质金属蛋白酶-9(MMP-9)、血管内皮生长因子受体 2(VEGF-R2)和/或胰岛素样生长因子结合蛋白 1(IGFBP-1)浓度处于最高四分位数的风险显著更高。这些增加的风险不能归因于分娩指征、菌血症或通气时间。
生长受限的早产儿在生后第 14 天似乎更易出现炎症相关蛋白浓度升高。