ABSTRACT
OBJECTIVE: Adiponectin levels measured in neonatal dried blood spot samples (DBSS) might be affected by both prematurity and being born small for gestational age (SGA). The aim of the study was to measure adiponectin levels in routinely collected neonatal DBSS taken on day 5 (range 3-12) postnatal from infants. DESIGN: A retrospective case-control study. SUBJECTS AND METHODS: One hundred and twenty-two infants: 62 very premature (34 SGA) and 60 mature infants (27 SGA). Adiponectin concentrations were determined in stored neonatal DBSS using a sandwich immunoassay based on flow metric Luminex xMap technology. RESULTS: Adiponectin was measurable in all samples, and repeated measurements correlated significantly (r = 0.94). Adiponectin concentrations were negatively associated with both SGA (B = -0.283, P = 0.04) and prematurity (B = -2.194, P < 0.001), independently of each other. In the premature but not the mature group, adiponectin levels increased with increasing postnatal age at blood sampling (B = 0.175, P < 0.001). CONCLUSIONS: Reliable quantification of adiponectin in stored DBSS is feasible and may be used to study large populations of routinely collected samples. Low levels of adiponectin in neonatal DBSS are associated with SGA as well as prematurity. Blood adiponectin levels increase with postnatal age in premature infants, suggesting a rapid yet unexplained metabolic adaptation to premature extrauterine life.
Subject(s)
Adiponectin/blood , Infant, Small for Gestational Age/blood , Birth Weight/physiology , Body Weight/physiology , Cross Reactions/physiology , Denmark/epidemiology , Female , Gestational Age , Humans , Infant, Newborn , Infant, Premature/blood , Male , Maternal AgeABSTRACT
INTRODUCTION: Early selective surfactant treatment of premature infants on mechanical ventilation, defined as treatment of selected children within the first two hours of life, reduces the incidence of complications to neonatal respiratory distress syndrome (RDS) as compared with delayed selective surfactant treatment. Treatment of children judged to be solely at risk of RDS, however, eventually leads to overtreatment in some. MATERIALS AND METHODS: A population of premature neonates born at a gestational age of 24 + 0 to 29 + 6 weeks at Rigshospitalet, were studied retrospectively. RESULTS: Of the 171 children supported by nasal continuous positive airway pressure (CPAP) at the age of two hours, 99 were eventually treated with a natural surfactant (Curosurf) at a median age of nine hours. A statistically significant association was found between later surfactant treatment and an oxygen supplement of more than 30% at the age of two hours (chi 2: p < 0.001). Furthermore, there was a statistically significant association between later surfactant treatment and birth as the second twin or second or third triplet (chi 2: p < 0.001). Surprisingly, a gestational age of between 24 + 0 and 27 + 6 weeks, a birth weight less than 1.000 g, and a birth weight less than 80% of that expected was not correlated with later surfactant treatment. Forty-nine per cent of the children treated with surfactant received mechanical ventilation at some time before discharge. DISCUSSION: Earlier selective surfactant treatment of premature neonates supported by nasal CPAP with an oxygen supplement of more than 30% at the age of two hours would have been possible in 71 of 99 children needing the surfactant. As a consequence, 13 of 72 children would have been overtreated.
Subject(s)
Biological Products , Phospholipids , Positive-Pressure Respiration , Pulmonary Surfactants/administration & dosage , Respiratory Distress Syndrome, Newborn/drug therapy , Female , Humans , Infant, Newborn , Infant, Premature , Infant, Very Low Birth Weight , Male , Practice Guidelines as Topic , Respiratory Distress Syndrome, Newborn/prevention & control , Respiratory Distress Syndrome, Newborn/therapyABSTRACT
We investigated the effect of local infusion with prostaglandin E2 (PGE2) in doses of 0.0003 to 4.0 mg/hour per kg body weight for 6 weeks on a plated unilateral osteotomy in rabbits. PGE2 caused a dose-dependent stimulation of callus formation. Total bone mineral content increased, although the mineral content per volume of the callus was reduced. In another experiment, PGE2 was infused either in the first half or in the second half of the healing period. No effect of PGE2 infusion could be observed in the first half of the 6-week healing period, whereas PGE2 infusion during the second half caused callus stimulation.
