A Comparison of Arginine Vasopressin Levels and Fluid Balance in the Perinatal Period in Infants Who Did and Did Not Develop Chronic Oxygen Dependency

Abstract

Arginine vasopressin (AVP) levels on days 1, 3 and 5 and fluid balance in the perinatal period were assessed in 60 infants, median gestational age 27 weeks (range 24–33). Fluid input and output, urine osmolality and episodes of hyponatraemia were recorded on a daily basis. Forty-one infants subsequently developed chronic lung disease (CLD), they were more immature, of lower birthweight and had higher AVP levels on days 3 and 5 (p < 0.05) than the rest of the cohort. Despite similar levels of fluid input, compared to the non-CLD infants, those who developed CLD had higher urine osmolalities on days 1, 5, 6 and 7 (p < 0.05), but there were not significant differences between the two groups regarding urine output or episodes of hyponatraemia. Logistic regression analysis revealed AVP levels on day 3 were significantly correlated with the duration of oxygen dependency independent of other factors. We conclude elevated AVP levels in the perinatal period are associated with CLD development, but our results suggest they have little functional significance.

Serial plasma vasopressin concentration in healthy and hospitalised neonatal foals

“…There is marked variability in reported vasopressin concentrations in both sick and control human infants among and between studies, similar to the foals in our study [28][29][30][31][32]. Values as low as 0.04-0.08 pmol/l have been measured in human infants, which are below the detection limit of some assays [32,33]. Another study measured values in man below the detection limit of the assay used in that study (<1.9 pmol/l) [34].…”

“…Human reference AVP values vary among laboratories and assays and some include 0 pmol/l [27,28]. There is marked variability in reported vasopressin concentrations in both sick and control human infants among and between studies, similar to the foals in our study [28][29][30][31][32]. Values as low as 0.04-0.08 pmol/l have been measured in human infants, which are below the detection limit of some assays [32,33].…”

The Human Neurosecretory Neurones Under Perinatal Hypoxia: A Quantitative Immunohistochemical Study of the Supraoptic Nucleus in Autopsy Material

“…It should be noted that, during labour, the levels of AVP are among the highest recorded in any area of human physiology, even 200-fold greater than the levels released by an osmotic challenge (11,21). AVP levels are found to correlate with the duration of oxygen dependency and are used as a measure of perinatal stress (22). In experimental studies using dehydration or salt loading (i.e.…”