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极早产儿在新生儿重症监护病房住院期间的血浆和尿液催产素变化轨迹

Plasma and Urinary Oxytocin Trajectories in Extremely Premature Infants During NICU Hospitalization.

作者信息

Weber Ashley, Harrison Tondi M, Sinnott Loraine, Shoben Abigail, Steward Deborah

机构信息

1 Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA.

2 The Ohio State University College of Nursing, Columbus, OH, USA.

出版信息

Biol Res Nurs. 2017 Oct;19(5):549-558. doi: 10.1177/1099800417718266. Epub 2017 Jul 12.

Abstract

Extremely premature infants are at great risk for poor neurodevelopmental outcomes, in part because neurologic structures designed to mature in the womb must now do so in the extrauterine environment. Reliable biomarkers of neurodevelopment are especially critical in this population, as behavioral measures can be unreliable due to immaturity of the premature infant nervous system. Oxytocin (OT) has the potential to be a marker of neurobiological processes that offer infant neuroprotection. However, no studies have measured OT in the plasma and urine of premature infants. The purposes of this study were to describe plasma and urine OT levels of premature infants through 34 weeks corrected gestational age (CGA), determine whether plasma and urine OT are correlated, and explore associations between infant demographics and OT trajectories. Plasma and urine from 37 premature infants, born at gestational ages 25-28 6/7 weeks, were longitudinally collected at 14 days of life, then weekly until 34 weeks CGA. Plasma OT decreased with age, at a rate of 15% per week, and exhibited strong stability within infants. Urine OT was not correlated with plasma OT and did not show a significant trend over time; thus, urine may not be a reliable, noninvasive measurement in this population. Apgar score was the only infant demographic characteristic associated with plasma OT. Given the novelty of this work, replication is needed to confirm these findings, and future research should explore potential mechanisms (e.g., stress, normal maturation, and social experiences) that contribute to declining plasma OT levels in premature infants.

摘要

极早产儿面临神经发育不良后果的巨大风险,部分原因是原本应在子宫内成熟的神经结构现在必须在宫外环境中完成这一过程。神经发育的可靠生物标志物在这一人群中尤为关键,因为由于早产儿神经系统不成熟,行为测量可能不可靠。催产素(OT)有可能成为提供婴儿神经保护的神经生物学过程的标志物。然而,尚无研究测量过早产儿血浆和尿液中的OT。本研究的目的是描述矫正胎龄(CGA)达34周的早产儿的血浆和尿液OT水平,确定血浆和尿液OT是否相关,并探讨婴儿人口统计学特征与OT轨迹之间的关联。对37名胎龄为25-28 6/7周的早产儿,在出生后14天纵向采集血浆和尿液,然后每周采集一次,直至CGA达34周。血浆OT随年龄下降,每周下降15%,且在婴儿体内表现出很强的稳定性。尿液OT与血浆OT不相关,且未显示出随时间的显著趋势;因此,尿液可能不是该人群可靠的非侵入性测量指标。阿氏评分是与血浆OT相关的唯一婴儿人口统计学特征。鉴于这项工作具有创新性,需要重复研究以证实这些发现,未来的研究应探索导致早产儿血浆OT水平下降的潜在机制(如压力、正常成熟和社会经历)。

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