Abstract
In accordance with the criteria for assessing the quality of medical care for prematurely born children, a study of serum creatinine is carried out on the first day of life. Elevated levels of the metabolite raise doubts about the advisability of prescribing a control analysis. The purpose of the study was to assess the level of serum creatinine in late preterm infants (34 to 36 weeks of gestation) in the early neonatal period for the correct interpretation of physiological changes in the blood. A retrospective cohort study of medical records was carried out, including an assessment of serum creatinine in late preterm infants on the first and on the 4th to 6th days of life. Two groups of participants were formed from 117 children: group 1 consisted of 62 premature babies with intrauterine growth restriction; group 2 included 55 premature babies with average physical development. The average creatinine level in late preterm infants varied from 85.0 (75.8; 101.6) µmol/l on the first day of life to 43.9 (28.8; 56.0) µmol/l on days 4th to 6th of life (p=0.001). Difference in creatinine level in children from G1 and G2 on the first day of life and at the end of the early neonatal period was not detected (p=0.864, p=0.104, respectively). A significant correlation was noted between the serum creatinine level in mother and child (p=0.001). The serum creatinine level in children in the first day of life is affected by the time of the day the blood sampling for analysis was taken. Thus, the average creatinine level in children at the beginning of the first day of life was 76.0 (68.4; 81.8) µmol/l and 101.6 (93.4; 110.9) µmol/l at the end of the first day of life (p=0.001). The high creatinine level in the first day of life reflects the maternal serum index with its subsequent decrease by the end of the early neonatal period which should be taken into account when assessing the postnatal adaptation of late preterm infants.
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