Files and links (1)
Published, Version of Record (VoR)CC BY-NC-ND V4.0, Open
Journal article
Cord Blood Haptoglobin, Cerebral Palsy and Death in Infants of Women at Risk for Preterm Birth: A Secondary Analysis of a Randomised Controlled Trial
EClinicalMedicine, v 9, pp 11-18
01 Mar 2019
PMID: 31143877
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Antenatal exposure to intra-uterine inflammation results in precocious Haptoglobin (Hp) expression (switch-on status). We investigated the relationships between foetal Hp expression at birth with newborn and childhood outcomes.
Methods: Weevaluated cord blood samples from 921 newborns of women at imminent risk for preterm delivery randomised to either placebo (n = 471, birth gestational age (GA) median [min-max]: 31 [24-41] weeks) or magnesium sulphate (n=450, GA 31 [24-42] weeks]). Primary outcome was infant death by 1 year and/or cerebral palsy (CP) >= 2 years of corrected age. Adjusted odd ratios (aOR) for neonatal and childhood outcomes were calculated controlling for GA, birth weight, sex, and magnesium exposure.
Findings: Primary outcome occurred in 2.8% of offspring. Newborns were classified in three pre-defined categorisation groups by cord blood Hp switch status and IL-6 levels: inflammation-nonexposed (Category 1, n = 432, 47%), inflammation-exposed haptoglobinemic (Category 2, n = 449, 49%), and inflammation-exposed anhaptoglobinemic or hypohaptoglobinemic (Category 3, n = 40, 4%). Newborns, found anhaptoglobinemic or hypohaptoglobinemic (Category 3) had increased OR for intraventricular haemorrhage (IVH) and/or death (aOR: 7.0; 95% CI: 1.4-34.6, p = 0.02) and for CP and/or death (aOR: 6.27; 95% CI: 1.7-23.5, p = 0.006) compared with Category 2. Foetal ability to respond to inflammation by haptoglobinemia resulted in aOR similar to inflammation-nonexposed newborns. Hp1-2 or Hp2-2 phenotypes protected against retinopathy of prematurity (aOR = 0.66; 95% CI 0.48-0.91, p = 0.01).
Interpretation: Foetal ability to switch-on Hp expression in response to inflammation was associated with reduction of IVH and/or death, and CP and/or death. Foetuses unable to mount such a response had an increased risk of adverse outcomes. (C) 2019 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license
Metrics
Details
- Title
- Cord Blood Haptoglobin, Cerebral Palsy and Death in Infants of Women at Risk for Preterm Birth: A Secondary Analysis of a Randomised Controlled Trial
- Creators
- Catalin S. Buhimschi - Ohio State Univ, Dept Obstet & Gynaecol, Columbus, OH 43210 USAKathleen A. Jablonski - George Washington UniversityDwight J. Rouse - University of Alabama at BirminghamMichael W. Varner - Univ Utah, Salt Lake City, UT USAUma M. Reddy - Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, Bethesda, MD USABrian M. Mercer - Case Western Reserve Univ, Metrohlth Med Ctr, Cleveland, OH USAKenneth J. Leveno - Southwestern Med Ctr, Dallas, TX USARonald J. Wapner - Drexel UniversityYoram Sorokin - University of Alabama at BirminghamJohn M. Thorp - University of North Carolina at Chapel HillSusan M. Ramin - University of Alabama at BirminghamFergal D. Malone - Columbia Univ, New York, NY USAMarshall W. Carpenter - University of Alabama at BirminghamMary J. O'Sullivan - Univ Miami, Miami, FL USAAlan M. Peaceman - University of Alabama at BirminghamGeorge R. Saade - Univ Texas Med Branch, Galveston, TX 77555 USADonald Dudley - The University of Texas Health Science Center at San AntonioSteve N. Caritis - Univ Pittsburgh, Pittsburgh, PA USAIrina A. Buhimschi - Nationwide Childrens Hosp, Ctr Perinatal Res, Res Inst, Columbus, OH USA
- Publication Details
- EClinicalMedicine, v 9, pp 11-18
- Publisher
- Elsevier
- Number of pages
- 8
- Grant note
- HD27869; HD34208; HD34116; HD40544; HD27915; HD34136; HD21414; HD27917; HD27860; HD40560; HD40545; HD40485; HD40500; HD27905; HD27861; HD34122; HD40512; HD53907; HD34210; HD21410; HD36801; HD19897; MO1-RR000080 / Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) Centre for Perinatal Research at The Research Institute at Nationwide Children's Hospital National Institute of Neurological Disorders and Stroke (NINDS); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Obstetrics and Gynecology
- Web of Science ID
- WOS:000646601300006
- Scopus ID
- 2-s2.0-85064549192
- Other Identifier
- 991021868718704721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Pediatrics