Hypoproteinemia on the first day of life and adverse outcome in very preterm infants admitted to the neonatal intensive care unit

Iacobelli, Simona; Bonsante, Francesco; Lacoutière, C.; Ferdynus, Cyril; Cottenet, Jonathan; Binquet, Christine; Quantin, Catherine; Gouyon, Jean‐Bernard

doi:10.1038/jp.2011.137

Cited by 8 publications

(16 citation statements)

References 22 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present cohort study, we could confirm our previous retrospective findings [4,5] that early hypoproteinemia is strongly associated with severe adverse outcome, defined as death or survival with severe neurological injury on cranial ultrasound in very preterm infants.…”

Section: Discussionsupporting

confidence: 80%

“…In summary, this study endorses the results of previous studies on the prognostic value of total plasma protein levels in very preterm infants [4,5], and confirms the research hypothesis that plasma protein levels are associated with cardiovascular function during transition. In this cohort, hypoproteinemia was significantly associated with hypotension during the first day of life and with lower SVR, even after the adjustment for gestational age.…”

Section: Discussionsupporting

confidence: 78%

“…The outcome measure was severe adverse outcome, defined as death or severe (grade 3 or 4) intraventricular hemorrhage according to the Papile grading system or cystic periventricular leukomalacia occurring before infants' discharge from hospital [4,5]. Cranial ultrasounds were routinely performed during the infant hospital stay according to the following protocol: days 1, 3, 7, 10, 15 and then at least every 2 weeks or more often as clinically indicated, until discharge.…”

Section: Methodsmentioning

confidence: 99%

“…Protein concentration was determined using the COBAS® 6000 automatic analyzer (Roche, Germany) and hypoproteinemia was defined as a total protein level <40 g/L on the blood sample at 12 h of life [4,5,9]. …”

Section: Methodsmentioning

confidence: 99%

“…In 2 previous reports [4,5,] we demonstrated that early hypoproteinemia (total plasma protein levels <40 g/L on the first day of life) is a strong independent factor in predicting severe adverse outcome (death or survival with major neurological abnormalities) in infants born at 24-31 weeks of gestation.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Low Plasma Protein Levels at Birth Are Associated with Poor Cardiovascular Adaptation and Serious Adverse Outcome in Infants with Gestational Age <32 Weeks: The ProHémie Study

Bonsante¹,

Ramful²,

Sampériz³

et al. 2017

Neonatology

View full text Add to dashboard Cite

Background: Retrospective studies suggest that early hypoproteinemia has prognostic value for adverse outcome in preemies, but the underlying pathophysiology is unknown. We hypothesized that the prognostic relevance of hypoproteinemia could be related to its association with impaired cardiovascular function and organ perfusion during transition. Objectives: To describe the plasma protein status and the measures of cardiovascular function according to the outcome in infants <32 weeks' gestation. Methods: One hundred and twenty-eight infants were prospectively included from birth to discharge. During the first 24 h of life, we assessed the cardiovascular function and systemic and organ blood flow by Doppler ultrasound, and monitored cerebral and renal regional oxygen saturation (cRSO₂, rRSO₂) using near-infrared spectroscopy. These measures were analyzed in relationship to hypoproteinemia (total plasma protein level <40 g/L at 12 h of life) and severe adverse outcome (death or survival with severe neurological injury). Results: Hypoproteinemia was associated with a higher risk of a severe adverse outcome after adjustment of confounding variables (adjusted OR = 6.8; 95% CI 1.3-34). Compared to normoproteinemic infants and after adjustment for gestational age, hypoproteinemic ones had more significantly: hypotension (7 vs. 13%, p = 0.03), abnormal capillary refilling time (20 vs. 36%, p < 0.001), abnormal renal blood flow (resistive index 0.78 ± 0.11 vs. 0.85 ± 0.09, p = 0.04), lower rRSO₂ (82.9 ± 9.2 vs. 73.6 ± 10.5%, p = 0.04), and lower systemic vascular resistance (0.155 ± 0.058 vs. 0.108 ± 0.037 mm Hg/L/kg; p = 0.04). The cRSO₂ patterns were significantly decreased in infants with severe adverse outcome and independent from protein status. Conclusion: Hypoproteinemia is associated with impaired cardiovascular function. Further studies are required to elucidate the interplay between changes in protein levels, postnatal hemodynamics and clinical outcome.

show abstract

Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 78%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Low Plasma Protein Levels at Birth Are Associated with Poor Cardiovascular Adaptation and Serious Adverse Outcome in Infants with Gestational Age <32 Weeks: The ProHémie Study

Bonsante¹,

Ramful²,

Sampériz³

et al. 2017

Neonatology

View full text Add to dashboard Cite

show abstract

Neonatal Refeeding Syndrome and Clinical Outcome in Extremely Low‐Birth‐Weight Babies: Secondary Cohort Analysis From the ProVIDe Trial

Cormack

Jiang

Harding

et al. 2020

J Parenter Enteral Nutr

View full text Add to dashboard Cite

Background Refeeding syndrome (RS) following preterm birth has been linked to high intravenous (IV) protein intake in the presence of low electrolyte supply. In extremely low‐birth‐weight (ELBW) babies, we aimed to determine the incidence of RS and associations with birth characteristics and clinical outcomes. Method Prospective cohort study of ELBW ProVIDe Trial participants in 6 New Zealand neonatal intensive care units. RS was defined as serum phosphate < 1.4 mmol.L−1 and total calcium > 2.8 mmol.L−1. Relationships between RS and other factors were explored using 2‐sample tests and logistic regression adjusted for sex, gestation, and birth‐weight z‐score. Results Of 338 babies (mean [SD] birth‐weight, 780 (134) g, gestational age, 25.9 [1.7] weeks), 68 (20%) had RS. Mortality was greater in babies with RS (32% vs 11%; P < .0001). More small‐ than appropriate‐for‐gestational‐age babies developed RS (22% vs 8%; P = .001). Growth from birth to 36 weeks’ corrected age was not different between babies who did and did not have RS. In logistic regression, the odds of RS decreased by 70% for each 1 mmol per kg−1.d−1 IV phosphate intake (odds ratio [OR], 0.3; CI, 0.1–0.6; P = .002) and increased by 80% for each 1 g.kg−1.d−1 IV protein intake (OR, 1.8; CI, 1.3–2.7; P = .002). Conclusions Neonatal RS is common in this cohort of ELBW babies and is associated with increased morbidity and mortality. Optimizing phosphate and calcium intakes in IV nutrition solutions may reduce RS and its consequences.

show abstract

Low albumin levels are independently associated with neonatal acute kidney injury: a report from AWAKEN Study Group

et al. 2021

View full text Add to dashboard Cite

Hypoproteinemia on the first day of life and adverse outcome in very preterm infants admitted to the neonatal intensive care unit

Cited by 8 publications

References 22 publications

Low Plasma Protein Levels at Birth Are Associated with Poor Cardiovascular Adaptation and Serious Adverse Outcome in Infants with Gestational Age <32 Weeks: The ProHémie Study

Low Plasma Protein Levels at Birth Are Associated with Poor Cardiovascular Adaptation and Serious Adverse Outcome in Infants with Gestational Age <32 Weeks: The ProHémie Study

Neonatal Refeeding Syndrome and Clinical Outcome in Extremely Low‐Birth‐Weight Babies: Secondary Cohort Analysis From the ProVIDe Trial

Low albumin levels are independently associated with neonatal acute kidney injury: a report from AWAKEN Study Group

Contact Info

Product

Resources

About