Dani Carlo, Remaschi Giulia, Monti Nicolò, Pizzetti Camilla, Pratesi Simone
Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy; Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy.
Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy.
Clin Chim Acta. 2023 Feb 15;541:117241. doi: 10.1016/j.cca.2023.117241. Epub 2023 Feb 2.
Carboxyhemoglobin (COHb) is considered a biomarker of oxidative stress and previous studies suggest a correlation between its blood level and prematurity complications. Our aim in this study was to assess the correlation between COHb levels and the risk for bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), and retinopathy of prematurity (ROP).
We retrospectively studied 178 preterm infants with gestational age of 27.0 ± 1.5 weeks, among which 121 (68 %) had BPD, 43 (24 %) IVH, and 33 (19 %) ROP. COHb levels measured during the first seven days of life were recorded.
Logistic regression analysis showed that higher levels of COHb on the seventh day of life increases the risk for moderate-to-severe BPD (OR 4.552, 95 % Cl 1.220-16.997; P = 0.024), while higher levels of COHb on the fourth day of life increases the risk for grade 2-4 IVH (OR 5.537, 95 % Cl 1.602-19.134; P = 0.007).
COHb measured in the first week of life can contribute to predicting the risk for BPD and IVH, but not for ROP, in very preterm infants. Since COHb can be readily measured, its assessment can be useful in clinical practice for early identification of preterm infants at high risk for oxidative stress related complications.
碳氧血红蛋白（COHb）被认为是氧化应激的生物标志物，先前的研究表明其血液水平与早产并发症之间存在相关性。本研究的目的是评估COHb水平与支气管肺发育不良（BPD）、脑室内出血（IVH）和早产儿视网膜病变（ROP）风险之间的相关性。
我们回顾性研究了178例胎龄为27.0±1.5周的早产儿，其中121例（68%）患有BPD，43例（24%）患有IVH，33例（19%）患有ROP。记录出生后前七天测量的COHb水平。
逻辑回归分析表明，出生后第七天较高的COHb水平会增加中重度BPD的风险（比值比4.552，95%置信区间1.220 - 16.997；P = 0.024），而出生后第四天较高的COHb水平会增加2 - 4级IVH的风险（比值比5.537，95%置信区间1.602 - 19.134；P = 0.007）。
出生后第一周测量的COHb有助于预测极早产儿患BPD和IVH的风险，但不能预测ROP的风险。由于COHb易于测量，其评估在临床实践中有助于早期识别有氧化应激相关并发症高风险的早产儿。
