Association of Immunoglobulin G at Birth with Late-Onset Sepsis and Related Mortality in Very Low Birth Weight Infants

PURPOSE: We aimed to evaluate the association between immunoglobulin G (IgG) at birth and late-onset sepsis (LoS) in preterm infants. METHODS: Medical records of very-low-birth-weight infants, born at gestational age <28 weeks, between 2013 and 2016, were retrospectively reviewed. Subjects were divided into two groups based on the occurrence of LoS (LoS vs. non-LoS), and IgG levels at 1 day, and at 2 weeks and 4 weeks after birth were investigated. IgG levels, other perinatal factors, and clinical factors were compared in the two groups. The relationship between IgG levels and mortality among infants in the LoS group was also analyzed. RESULTS: A total of 105 infants were analyzed after exclusion of cases with early onset sepsis or death at < 72 hours of life. Gestational age in the LoS group was lower than in the non-LoS group (25.0±1.8 vs. 26.3±1.4 weeks, P=0.004). IgG levels at birth were similar between the two groups (236.4±96.4 vs. 282.0±104.7 mg/dL, P=0.078). Multivariate analysis showed that IgG at birth was not an independent risk factor for LoS. In the LoS group, IgG levels at birth were comparable between survivors and cases involving mortality. CONCLUSION: IgG levels at birth were not associated with the occurrence of LoS in extremely preterm infants.

Comparisons of Clinical Characteristics Affecting Readmission between Late Preterm Infants and Moderate Preterm Infants or Full-Term Infants

PURPOSE: We aimed to describe the differences in clinical characteristics that affect readmission between late and moderate preterm or full-term infants. METHODS: Medical records were reviewed for 881 patients with gestational ages of ≥31⁺⁰ weeks who were born at Inje University Sanggye Paik Hospital between1 January 2013 and 20 September 2015. The patients were categorized into three subgroups as follows moderate preterm infants: those born at 31-33 weeks' gestation (n=73), late preterm infants: those born at 34–36 weeks' gestation (n=169),and full-term infants: those born at ≥37 weeks' gestation (n=639). We compared the late and moderate preterm or full-term infants in terms of clinical characteristics that affect readmission. RESULTS: The readmission rate was 18.9% in the late preterm infants, 21.9% in the moderate preterm infants, and 16.7% in the full-term infants. The independent risk factors of readmission were gestational age in the late preterm infants, positive pressure ventilation at birth in the moderate preterm infants, and air-leak syndrome in the full-term infants. In addition, antenatal care at the first trimester of pregnancy was an independent protective factor against readmission in the full-term infants. CONCLUSION: Our results suggest that gestational age may affect the readmission rate of late preterm infants.