DESACYLATED GHRELIN AND LEPTIN IN THE CORD BLOOD OF SMALL-FOR-GESTATIONAL-AGE NEWBORNS WITH INTRAUTERINE GROWTH RESTRICTION.

CONTEXT: Ghrelin, in both its acylated and desacylated forms, and leptin can modulate fetal energy balance and development. OBJECTIVE: The aim of our study is to assess desacylated ghrelin (DAG) and leptin values and influence on intrauterine and postnatal growth in infants with intrauterine growth restriction. DESIGN SUBJECTS AND METHODS: We performed a prospective study on 39 infants recruited over five months, 20 appropriate - for - gestational - age (AGA) infants and 19 small-for-gestational-age (SGA) infants, in which we measured DAG and leptin in the umbilical cord blood and we compared their respective values between the two groups, along with auxological parameters at birth and at 10 months of postnatal age. RESULTS: Our results show that both DAG and leptin have lower values in SGA infants and correlate with most of the anthropometrical parameters at birth. Both hormones correlate with weight at 10 months in SGA infants, but this correlation lacks in AGA infants. Whereas DAG in the cord blood can be considered a predictor for weight at 10 months (ß=0.207, p=0.001), the same cannot be stated about leptin (ß=0.078, p=0.195). CONCLUSION: DAG and leptin are involved in both intrauterine and postnatal development, but the extent of their role is still to be determined.

[Antenatal corticosteroid therapy and the effects on complications of prematurity]. / Terapia antenatala cu corticosteroizi si efectele asupra complicatiilor prematuritatii.

UNLABELLED: The respiratory distress syndrome (RDS) in the preterm neonates is the most frequent cause of morbidity and mortality in neonatal units. Corticosteroids were shown to have multiple beneficial effects in maturing fetal surfactant and in decreasing the incidence and severity of RDS, intraventricular hemorrhage and necrotizing enterocolitis. MATERIAL AND METHODS: The authors studied 65 premies treated antenatally with corticosteroids versus 68 preterm neonates that didn't benefit from this therapy. All cases presented life threatening distress by various causes. There were evaluated the incidence of hyaline membrane disease, incidence related with gender, gestational age, the severity of respiratory distress (Silverman score), influence of the therapy on Apgar score, onset of symptomes and haematologic status, necessity of assisted ventilation and neonatal mortality. RESULTS: We found a significant decrease in the incidence of RDS (40%), severity of vital life-threatening distress and neonatal mortality (60%). There were no significant side effects for the babies treated versus untreated. CONCLUSIONS: Antenatal steroids given to the mother in imminence of premature birth are for real benefit in reducing neonatal mortality, increasing the number of survivors among small prematures and improving their quality of life. Even life threatening distress from other causes seem to be less severe, and even an incomplete course therapy conduces to decrease of distress severity.

[The presence in pregnant women of the risk factor of serum antibodies against 9 viruses with significance in materno-infantile pathology and the transfer of these antibodies to the newborns]. / Prezenta la gravide cu factor de risc de anticorpi serici fata de noua virusuri cu semnificatie în patologia materno-infantila si transferul acestor anticorpi la nou-nascut.

Indirect enzyme immunoassay, performed with Labsystems (Helsinki) kits, in 30 mothers and their newborns, revealed that 100% of parturient women present IgG antibody to hepatitis A (HAV), herpes simplex 1, and measles viruses, constantly transferring these antibodies to their newborns. 78.6% of the women had IgG to rubella (German measles) virus, passively transmitting them to their offsprings. Serological markers (HBsAg and anti-HBc) of hepatitis B virus infection were present in 42% of the investigated women, anti-HBc being also present in the serum of the newborns. Between the identified risk factors (in the past obstetrical history, current pregnancy, labor and early postnatal period) and the spectrum of IgG antibodies present in mothers no significant correlations were revealed. The same obvious lack of correlation between IgG antibodies and risk factors in the neonate (prematurity, low birth weight, malformations) was also found. However, the presence of IgG anti-measles (2 case), IgM anti-rubella (1 case) and IgM and HAV (4 cases) was associated, in the same order, with interstitial pneumonia, hepatosplenomegaly and death, icterus neonatorum, cardiovascular and neurologic malformations. Neither mothers nor their offsprings presented anti-HIV antibodies, suggesting that in the investigated patients no perinatal transmission had occurred.