Department of Pediatrics I, Neonatology, Pediatric Intensive Care, Pediatric Neurology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany.
Department for Medical Statistics and Biomathematics, University Hospital Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
Pediatr Neonatol. 2020 Aug;61(4):414-419. doi: 10.1016/j.pedneo.2020.03.010. Epub 2020 Mar 24.
The reason for increased serum creatinine levels in preterm infants often remains unclear. We aimed to determine whether postnatal serum creatinine in preterm infants correlates with intake of amniotic fluid, represented by the amount of amniotic fluid after preterm premature rupture of membranes (PPROM).
74 preterm infants with PPROM > 48 h duration were retrospectively studied. Postnatal creatinine concentration was determined at day 2-5, 10-17 and 26-33 of life and compared between infants with normal intrauterine amniotic volumes, oligohydramnios and anhydramnios.
Mean gestational age of included patients was 29.7 weeks (range: 24.0-36.1 weeks) and mean birth weight was 1452 g (range: 560-2940 g). Serum creatinine concentration was similar at day 2-5 and day 10-17 of life between the three groups. We observed a significant decrease in creatinine concentration from day 2-5 to day 26-33 in infants with normal amniotic fluid volume and oligohydramnios (p = 0.0001 and p = 0.0071, respectively), but not in anhydramnios. On day 26-33 of life, infants with anhydramnios showed significantly higher creatinine levels compared to infants with normal amniotic fluid volume and oligohydramnios (p = 0.0211).
Postnatal serum creatinine of preterm infants at day 26-33 of life is elevated in infants with PPROM-induced anhydramnios, but not in oligohydramnios.
早产儿血清肌酐水平升高的原因往往仍不清楚。我们旨在确定早产儿出生后血清肌酐是否与羊水摄入有关，以胎膜早破（PPROM）后羊水的量来表示。
回顾性研究了 74 例持续时间超过 48 小时的有 PPROM 的早产儿。在出生后第 2-5、10-17 和 26-33 天测定血清肌酐浓度，并比较羊水量正常、羊水过少和无羊水的婴儿之间的差异。
纳入患者的平均胎龄为 29.7 周（范围：24.0-36.1 周），平均出生体重为 1452g（范围：560-2940g）。三组间第 2-5 天和第 10-17 天的血清肌酐浓度相似。我们观察到羊水量正常和羊水过少的婴儿从第 2-5 天到第 26-33 天的肌酐浓度显著下降（p=0.0001 和 p=0.0071），但无羊水的婴儿则没有。在第 26-33 天，无羊水的婴儿的肌酐水平明显高于羊水量正常和羊水过少的婴儿（p=0.0211）。
在有 PPROM 引起的无羊水的早产儿中，出生后第 26-33 天的血清肌酐升高，但在羊水过少的早产儿中则没有。
