Correlation between umbilical artery erythropoietin level and perinatal factors in premature infants and its clinical significance / 第二军医大学学报

ABSTRACT

Objective: To explore the correlation between umbilical artery blood erythropoietin (EPO) level and perinatal factors in premature infants and its clinical significance. Methods: Umbilical artery blood samples from 107 premature infants born in the Eastern Branch of Shanghai First Maternity and Infant Hospital of Tongji University between Jan. 2019 and Jun. 2019 were collected. The levels of EPO and ferritin were measured by ELISA and chemiluminescence assay, respectively. The 107 infants were divided into three groups according to the quartile EPO level low level group, medium level group and high level group. The relationship between umbilical artery blood EPO level and gestational age, birth body mass and other perinatal factors, the incidence of anemia of prematurity (AOP), necrotizing enterocolitis (NEC), patent ductus arteriosus (PDA) and atrial septal defect (ASD) in premature infants, and the clinical characteristics of pregnant mothers was analyzed. Results: The EPO level of umbilical artery blood in 107 newborn premature infants was 5.94-137.18 mU/mL, and the median level was 23.51 (14.60, 51.28) mU/mL. There were 26 cases in the low level group (the EPO level 14.60 mU/mL), 54 in the medium level group (14.60-51.27 mU/mL), and 27 cases in the high level group (≥51.28 mU/mL). Univariate analysis showed that the gestational age of the infants in the low level group was significantly lower than those in the medium level group and the high level group (both P < 0.05), the age of the pregnant mothers was significantly higher than those in the medium level group and the high level group (both P < 0.05), the natural pregnancy rate was significantly lower than that in the high level group (P < 0.05), and the continuous positive airway pressure (CPAP) usage rate of the infants was significantly higher than that in the medium level group (P < 0.05). The ferritin level of umbilical artery blood was significantly higher in the midium level group than that in the high level group (P < 0.05). The incidence of AOP in the high level group was significantly higher than that in the midium level group (P < 0.05). Multiple linear regression analysis showed that the EPO level of umbilical artery blood was positively correlated with the gestational age of newborn premature infants and the natural pregnancy rate of pregnant mothers (both P < 0.01). Multivariate logistic regression analysis showed that the higher the natural pregnancy rate, the higher the level of EPO in umbilical artery blood, and the higher the natural delivery rate, the lower the level of EPO in umbilical artery blood. The risks of PDA and NEC decreased and the risk of ASD increased with the increase of EPO level in umbilical artery blood (all P < 0.05). Conclusion: Conception method and delivery mode are the influencing factors of EPO level in umbilical artery blood. Monitoring the EPO level of umbilical artery blood is helpful to diagnose the common complications such as AOP, PDA, ASD and NEC in premature infants.