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Plasma midregional proadrenomedullin (MR-proADM) in newborn infants: Impact of prematurity and perinatal infection.
MedLine Citation:
PMID:  22447319     Owner:  NLM     Status:  Publisher    
Background:Adrenomedullin (ADM) is one of the strongest endogenous vasodilating hormones. Its stable by-product midregional-proADM (MR-proADM) is an established indicator of systemic infection and cardiovascular compromise in adult patients.Methods:A prospective cross-sectional study was performed to investigate perinatal factors affecting MR-proADM plasma concentrations in 328 newborn infants with a gestational age (GA) between 24 and 41 weeks.Results:Blood samples were obtained in 270 infants from umbilical veins (with additional 108 paired samples from umbilical arteries), and at day 2-3 of life in 183 infants. Paired venous and arterial umbilical cord MR-proADM concentrations were closely related (R(s) 0.825, p<0.001). MR-proADM concentrations at birth and at day 2-3 were inversely related to GA (R(s) -0.403 and R(s) -0.541, respectively) and birth weight (R(s) -0.421 and Rs -0.530, respectively; all p<0.001). On stepwise regression analysis, clinical chorioamnionitis and umbilical arterial blood base excess retained a significant impact on MR-proADM cord venous blood concentrations. At days 2-3 of life, histologic chorioamnionitis and GA at delivery were significantly associated with MR-proADM levels.Conclusions:Compared to adults, MR-proADM concentrations are elevated in neonates, especially those born very preterm. Immaturity and infection which both feature low systemic vascular resistance are related to increased MR-proADM concentrations.
Deborah Admaty; Jörg Benzing; Tilo Burkhardt; Olav Lapaire; Lukas Hegi; Gabor Szinnai; Nils G Morgenthaler; Hans Ulrich Bucher; Christoph Bührer; Sven Wellmann
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-23
Journal Detail:
Title:  Pediatric research     Volume:  -     ISSN:  1530-0447     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Division of Neonatology, University Hospital Zürich, CH-8091 Zürich, Switzerland.
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