Blood Of Newborn Infants Research Articles

Comparison of Malondialdehyde Level in the Cord Blood of Newborn Infants of vaginal and cesarean deliveries

The oxidative stress injury that has been linked to poor perinatal outcome and birth asphyxia may be found even with normal pregnancy, and it is severity in a newborn may be related to modes of delivery for which our study aimed to identify. Furthermore, this study was aimed to study the effect of both related- maternal, and related neonatal characteristics on baby’s oxidative stress marker level (Malondialdehyde). Fifty newborn children were selected in both labor ward and operating theatre of Al-Sadder Teaching Hospital, Misan, Iraq. They were divided into two groups. The first group comprised 28 newborns, who were born by a vaginal delivery; the second group consisted of 22 newborns who delivered by elective cesarean section. The laboratory measurement of levels of an important antioxidant factor [malondialdehyde (MDA)] in baby’s cord blood has been extracted and used as an indicator of stress. We compared the two samples of different malondialdehyde levels in relation to variables as the delivery type, some maternal, fetal and neonatal characteristics. The results of this study revealed that MDA level was higher among neonates delivered through Elective Cesareans Section than those delivered through Vaginal Delivery with significant statistical value (p>0.0001). The previous delivery mood has a statistically significant value of (p>0.02) among mothers who had no previous deliveries. While there were no significant statistical values regarding maternal characteristics as (ages, parity, residency, antenatal care, history of previous abortion, and body mass index) as well as fetal and neonatal characteristics as (sex, birth weight, fetal presentation, and Apgar score) and high MDA level. The current study was concluded that babies delivered by Elective Cesarean Section had been exposed to more oxidative stress compared to the normal Vaginal Deliveries especially for the Primigravidas.

Maternal intrapartum antibiotic treatment continues to exert a bactericidal effect on the umbilical cord and peripheral venous blood of newborn infants.

It is unclear whether maternal intrapartum antibiotic treatment (IAT) continues to exert a bactericidal effect on common pathogens in neonates. We studied the in vitro bactericidal effect of IAT on the cord and peripheral venous blood of newborn infants. Umbilical cord and peripheral venous blood from newborn infants born at Kaplan Medical Center, Israel, from April to October 2014 were studied for serum bactericidal titres against Group B Streptococcus (GBS) and Escherichia coli (E. coli) strains. We studied 60 samples of umbilical cord blood and 18 samples of peripheral venous blood from 60 newborn infants whose mothers received IAT. The controls were 10 samples of cord blood from mothers without IAT. Cord blood exerted a bactericidal effect against 98% of GBS isolates but only 8% of E.coli isolates. Peripheral blood exerted a bactericidal effect against GBS in 94% of cases, but not against E. coli. No bactericidal effect was seen in the blood from the controls. We found a continued bactericidal effect of umbilical cord blood and neonatal peripheral blood from newborn infants of IAT-treated mothers, mainly against GBS, but rarely against E. Coli. These findings may assist clinicians treating at-risk infants exposed to IAT.

Three-dimensional refractive index tomograms and deformability of individual human red blood cells from cord blood of newborn infants and maternal blood.

Red blood cells (RBCs) from the cord blood of newborn infants have distinctive functions in fetal and infant development. To systematically investigate the biophysical characteristics of individual cord RBCs in newborn infants, a comparative study was performed on RBCs from the cord blood of newborn infants and from adult mothers or nonpregnant women using optical holographic microtomography. Optical measurements of the distributions of the three-dimensional refractive indices and the dynamic membrane fluctuations of individual RBCs were used to investigate the morphological, biochemical, and mechanical properties of cord, maternal, and adult RBCs at the individual cell level. The volume and surface area of the cord RBCs were significantly larger than those of the RBCs from nonpregnant women, and the cord RBCs had more flattened shapes than that of the RBCs in adults. In addition, the hemoglobin (Hb) content in the cord RBCs from newborns was significantly higher. The Hb concentration in the cord RBCs was higher than that in the nonpregnant women or maternal RBCs, but they were within the physiological range of adults. Interestingly, the amplitudes of the dynamic membrane fluctuations in cord RBCs were comparable to those in nonpregnant women and maternal RBCs, suggesting that the deformability of cord RBCs is similar to that of healthy RBCs in adults.

Brain-derived circulating endothelial cells in peripheral blood of newborn infants with seizures: a potential biomarker for cerebrovascular injury.

Neonatal seizures have been associated with cerebrovascular endothelial injury and neurological disabilities. In a piglet model, the long-term loss of endothelial regulation of cerebral blood flow coincides with the surge of brain-derived circulating endothelial cells (BCECs) in blood. We hypothesized that BCECs could serve as a noninvasive biomarker of cerebrovascular injury in neonates with seizures. In a prospective pilot feasibility study, we enrolled newborn infants with confirmed diagnoses of perinatal asphyxia and intraventricular hemorrhage (IVH); both are commonly associated with seizures. Infants without clinical evidence of cerebrovascular injuries were representative of the control group. BCECs were detected in the CD45-negative fraction of peripheral blood mononuclear cells by coexpression of CD31 (common endothelial antigen) and GLUT1 (blood-brain barrier antigen) via automated flow cytometry method. In Infants with asphyxia (n = 12) and those with IVH grade III/IV (n = 5), the BCEC levels were 9.9 ± 0.9% and 19.0 ± 2.0%, respectively. These levels were significantly higher than the control group (n = 27), 0.9 ± 0.2%, P < 0.001. BCECs in infants with cerebrovascular insults with documented clinical seizures (n = 10; 16.8 ± 1.3%) were significantly higher than infants with cerebrovascular insults with subclinical or no seizures (n = 7; 9.5 ± 1.2%); P < 0.001. BCEC levels decreased with seizure control. BCECs levels were elevated in infants with seizures caused by severe IVH and perinatal asphyxia. We suggest that monitoring BCEC levels in peripheral blood can potentially offer a biological marker that reflects cerebrovascular insult and recovery. Further studies with a larger number of patients are required to support these findings.

Herpes simplex virus: Prevalence in placental tissue and incidence in neonatal cord blood samples

Herpes simplex virus (HSV) infection is one of the most prevalent infectious diseases worldwide, with HSV-2 being primarily associated with genital infections. HSV-2 is believed to account for the majority of cases of neonatal herpes, which may cause diverse of complications in infected newborns. The present study sought to estimate the prevalence of HSV-2 in placental tissue samples and the incidence of HSV-2 in the umbilical cord blood of newborn infants. Placental tissue samples from 201 women (maternal-side and fetal-side = 402 specimens) and 184 neonatal cord blood samples, all collected at the obstetric ward of a University hospital were studied. HSV-2 was detected by means of nested PCR. The prevalence of HSV-2 in placental samples was 9.0% (n = 18), and the incidence of neonatal HSV-2 infection was 1.1% (n = 2). All HSV-2-positive patients were asymptomatic at the time of delivery and none reported genital herpes. Women with a time between rupture of membranes and delivery of ≥360 min had an approximately fourfold risk of HSV-2 infection in the placental tissue (95% CI 0.93-5.66, P = 0.01). These results suggest that HSV-2 is present in the placenta of asymptomatic women and that a risk of transmission to the neonate exists. New strategies must be implemented for the management of asymptomatic patients who are capable of transmitting the virus to the newborn.

Cord blood plasma reference intervals for potential sepsis markers: Pro-adrenomedullin, pro-endothelin, and pro-atrial natriuretic peptide

Objectives To establish reference values in cord blood of the following new sepsis markers: pro-adrenomedullin (MR-proADM), pro-endothelin (CT-proET-1), and pro-atrial natriuretic peptide (MR-proANP). Methods MR-proADM, CT-proET-1, MR-proANP, and procalcitonin (PCT) were measured in cord blood of newborn infants by Time Resolved Amplified Cryptate Emission (TRACE) technology. The inclusion criteria in the control group ( n = 194) was the absence of any clinical sign or risk factor of sepsis. A group of 73 newborn infants presenting with risk factors of sepsis at delivery was also studied. Results The median values (reference interval) of CT-proET-1, MR-pro-ADM, and MR-proANP measured in cord blood plasma were 72 pmol/L (39–115), 0.84 nmol/L (0.5–1.38), and 163 pmol/L (76–389), respectively. The PCT reference interval was not significantly different from that previously described in cord blood serum. Conclusions The reference intervals established will serve as a starting point for further clinical investigations aimed to elucidate the potential prognostic/diagnostic value of these markers in neonatal sepsis management.

Detection of brain‐derived circulating endothelial cells in peripheral blood of newborn infants with cerebrovascular disorders

Cerebrovascular disorders in neonates may contribute to long‐term neurological complications. Early detection of cerebrovascular damage is important for clinical management and prognosis. However, early diagnosis of cerebrovascular injury in clinical settings remains challenging. Based on our data, seizures are accompanied by the early appearance of circulating endothelial cells (CECs) of brain origin (BCECs) in blood of newborn piglets that coincides with the late loss of endothelial‐dependent regulation of cerebral blood flow. We hypothesized that BCECs of human neonates with cerebrovascular disorders could provide a non‐invasive diagnostic approach for detecting cerebrovascular injury. Newborn infants with seizures, asphyxia, intraventricular hemorrhage and infection, which may cause cerebrovascular injury, were included in our study. Blood samples were collected from neonates. BCECs were immunodetected by co‐expression of endothelial‐specific (CD146 and CD31) and brain‐specific (GLUT‐1) antigens. In control infants BCECs were not detectable. Conversely, BCECs were detected in preterm infants with sustained seizures. These data suggest that BCECs may be helpful in clinical setting when acting within a small therapeutic window is critical for prophylactic/rescue intervention to improve long‐term neurological outcome in infants with cerebrovascular insults.

Gender differences in serum leptin concentrations from umbilical cord blood of newborn infants born to nondiabetic, gestational diabetic and type-2 diabetic mothers

To investigate gender differences, if any, in leptin concentrations from umbilical cord blood of new born infants of mothers with type 2 diabetes mellitus (DM), gestational diabetes mellitus (GDM), and Non diabetic (ND) at delivery. Serum leptin concentrations were measured in 105 newborns (53 males and 52 females in the three groups). Blood was taken from the umbilical cord of the babies at delivery. Maternal anthropometric measurements were recorded within 48 hours after delivery. Pearson correlation coefficient was used to explore the relationship between serum leptin concentrations and anthropometric measures of the fetus and their mother. Both Serum leptin level and serum C-peptide was measured by chemiluminescence based ELISA. The median range of leptin concentration in cord blood was ND group: Male [13.91 (3.22 – 47.63)], Female [16.88 (2 – 43.65)]; GDM group: Male [32 (7 – 76.00)], Female [36.73 (4.80 – 81.20)]; DM group: Male [20.90 (2 –76.00)], Female [32 {2.58 – 80.67)]. Cord serum leptin levels correlated with birth weight(r=0.587, p=0.0001), ponderal index (PI) (r=.319, p=0.024)of the babies and body mass index (BMI) (r=−0.299, p=0.035) of their mothers but did not correlate with gestational age, cord serum C-peptide concentration or placental weight at delivery. Leptin concentrations were higher in the female fetus in comparison to the male fetus. Birth weight of the female fetuses were also higher than that of male fetus. We found that there are very strong associations between cord leptin concentrations at delivery and birth weight, ponderal index of the baby, body mass index of the mothers with Type 2 DM. We also found that high leptin levels could represent an important feedback modulator of substrate supply and subsequently for adipose tissue status during late gestation or adipose tissue is the major determinant of circulating leptin levels.

Polyamine oxidase activity in peripheral blood of newborn infants with neonatal hyperbilirubinemia: Is bilirubin an antioxidant?

Neonatal hyperbilirubinemia can be physiological and pathological and most frequently is a consequence of faster erythrocytes (RBC) hemolysis. Free unconjugated bilirubin is a highly toxic compound, especially for the central nervous system. The most abundant polyamines circulating in blood are spermidine (Spd) and spermine (Sp), which are mainly localized in RBC, where they control membrane permeability. Polyamine oxidase (PAO) exerts an important activity in the plasma and erythrocytes of newborn infants with hyperbilirubinemia, catalyzing the oxidative deamination of Sp and Spd, producing potentially toxic agents that induce apoptosis of mammalian cells. The present study investigated polyamine metabolism by measuring PAO activity in the blood of newborn infants with hyperbilirubinemia and explored the possible antioxidant function of bilirubin through monitoring malondialdehyde (MDA) levels. The study included 43 newborns, 10 in the control and 33 in the diseased group. Blood PAO activity and bilirubin and MDA levels were measured using spectrophotometric methods. Our results indicate that bilirubin, at physiologic concentrations, protects neonatal erythrocytes against oxidative stress. The positive correlation between PAO activity and MDA levels with high bilirubin concentrations (> 200 micromol/L) in newborn infants indicates that in pathological conditions, bilirubin cannot exert its antioxidant function. Investigating the function of polyamines in erythrocytes and the importance of PAO related to hemolysis and bilirubin synthesis is necessary to shed light on the functions of PAO and its metabolites on the permeability of the erythrocyte membrane.

Rubella screening using the haemolysis-in-gel test from dried newborn blood on filter paper (author's transl)

Dried whole blood of newborn infants on filter paper which is generally used for screening investigations for inborn errors of metabolism has been found suitable in a pilot study for demonstration of rubella antibodies. Investigation of 2522 newborn blood samples using the haemolysis-in-gel test showed lack of rubella specific antibodies of the IgG type in 236 cases. This indicates that 9.3% of mothers had no immunity against rubella. Inclusion of the test into existing newborn screening programmes would permit selective immunisations in the lying in period, discovery of rubella infections within the first months of pregnancy, and permit epidemiological studies. Financial and organisational requirements would be minimal. A considerable improvement in current rubella prophylaxis could thus be achieved.

Acid-base and gas-transfer properties of the blood of newborn infants

The concentration of HCO3−, pH, pO2, sO2, and pCO2 were measured in the total umbilical blood of neonates born in January–February (n = 169) and June–July (n = 172). The former group displayed higher values of pH, pO2, and sO2, whereas pCO2 and the concentration of HCO3− were higher in the latter group. There was a 70–80% coincidence of the variants in both groups (the regions of statistical transgressions); seasonal factors were responsible for 20–30% of the differences.

The Influence of Gestation and Mechanical Ventilation on Serum Clara Cell Secretory Protein (CC10) Concentrations in Ventilated and Nonventilated Newborn Infants

Clara cell secretory protein (CC10) is an important anti-inflammatory mediator in the adult lung, but its role in newborn pulmonary protection is uncertain. We examined the early postnatal behavior of CC10 in newborn serum and tracheal fluid and hypothesized that CC10 production is positively influenced by gestation. Blood from 165 infants from the first, third/fourth, and seventh days of life (gestational ages: 23-29 wk, 30-36 wk, >36 wk) and tracheal fluid (TF) from the first day of life from 32 ventilated infants were analyzed for CC10. Surfactant proteins A (SPA) and B (SPB) were also analyzed from the blood of a subgroup of infants. Serum CC10 on day 1 was highest in term infants (69.4 ng/mL), followed by moderately preterm (55.8 ng/mL), and then extremely preterm infants (median 42.1 ng/mL). Term infants also had higher tracheal fluid CC10 than preterm infants. (20.152 ng/mL versus 882 ng/mL). Mechanical ventilation increased serum CC10 only in moderately preterm infants, and only on d 1 [68.4 ng/mL versus 42.1 ng/mL (nonventilated moderately preterm infants)]. Serum CC10 decreased progressively by the end of the first week in all infants, in contrast to SPA and SPB, which increased. Our results show that CC10 is detectable in the blood of newborn infants and that a production surge occurs at birth. This surge is more pronounced in term infants and may confer them with superior extrauterine pulmonary protection compared with preterm infants.

Detection of maternal deoxyribonucleic acid in peripheral blood of premature and mature newborn infants

Over the past decade, a lot of attention has been directed towards the fetomaternal and maternofetal transfer of nucleated cells and plasma DNA. In some autoimmune diseases, the fetal DNA is suspected to play an important role in the etiology of the disease. In the same way, the presence of maternal cells and free plasma DNA in fetal/newborn circulation gives rise to interesting questions. The aim of our study was to detect maternal deoxyribonucleic acid in the peripheral blood of premature and mature newborn infants. In the case of eight RhD-positive mothers-RhD-negative newborn pairs, peripheral blood samples were collected from the newborn infants within 35-120 min after birth. The maternal origin DNA was determined by real-time PCR amplification of the exon 7 of the RhD-positive allele. In all eight cases, the RhD exon 7 was amplified during the PCR reaction. The result of our study demonstrates that maternal DNA is present in the fetal peripheral circulation. The presence of maternally derived cells/DNA in the blood of newborn infants might have a role in the immunization of the newborn infants and also could be a possible explanation for 'grandmother effect' in the case of Rh-negative nulligravida patients.

257 Low Proportions of Peripheral Blood TCRãä-Cells in Newborn Infants

Background: Majority of peripheral blood T-cells express the áâT-cell receptor (TCRáâ), which recognizes specific MHC-bound antigens. In the adult, 5–10% of blood T-cells express the TCRãä-receptor. TCRãä-cells recognize antigens in a non-MHC-restricted manner and are part of innate immunity. They are thought to act in defence against microbial pathogens and may play a role in controlling inflammation and preventing chronic inflammatory reactions. Newborn infants, especially those born very preterm, are susceptible to infections. In preterm infants inflammation may play a role in the development of chronic complications. However, little is known about the T-cell subsets in the perinatal period in newborn infants. The aim of this study was to evaluate the TCR áâ and ãä -subsets in the peripheral blood in newborn preterm and term infants in comparision with adults.Methods: Peripheral blood was drawn on the first day of life from 45 preterm infants [gest. age (GA) 28.3(10.3)wks; birth weight (BW) 1000(1780)g], 12 healthy term infants, and 33 healthy adult volunteers. From the preterm infants, follow-up blood samples were drawn at the age of 1, 2, 4, and 6 weeks. T-cell subpopulations were analyzed by flow-cytometry using fluorescent antibodies.Results: In newborn preterm infants, the proportion of T-cells presenting TCRãä was lower than in term infants [median (range) 1.5(3.8) vs 3.1(3.0) %; p<0.001], and in adult controls [5.9(14.8);p<0.001]. In term newborns the proportion of TCRãä-cells was lower than in adults (p=0.001) (Figure). The blood TCRãä-cell counts were lower in preterm infants than in term infants [0.030(0.11) vs 0.091(0.10) 10E9/L;p<0.001] or adults [0.08(0.25)10E9/L;p<0.001]. The blood TCRãä-cell counts were similar in term infants and adults. The blood TCRãä-cell counts gradually increased during the follow-up in the preterm infants, and at the age of 6 wks they were comparable with the term infants' level at d1 [0.081(0.28) vs 0.091(0.10)].Conclusion: The low proportion of TCRãä-cells in the peripheral blood of newborn infants may contribute to their susceptibility to infections. Furthermore, in preterm infants this may contribute to development of chronic inflammation seen in complications such as bronchopulmonary dysplasia.

Lack of circulating megakaryoblasts in newborn peripheral blood: development and validation of a sensitive flow cytometric detection method.

It is currently thought that approximately 1% of children with Down syndrome will develop a "premalignant" syndrome known as transient myeloproliferative disorder (TMD). Prospective, population-based studies of the incidence of TMD in Down syndrome infants is lacking. Although most cases of TMD resolve by 1 year of age, data suggest that 10% to 20% of Down syndrome patients with TMD develop AML-M7 (megakaryoblastic leukemia). To identify the true incidence of TMD in the Down syndrome population, a sensitive, rapid, and cost-effective method of quantifying circulating megakaryoblasts in large numbers of patients was needed. In this pilot study, the authors tested the hypothesis that there are fewer than 1% megakaryoblasts of nucleated cells circulating in the blood of normosomic infants. Four-antigen flow cytometry was used to establish the percentage of megakaryoblasts present in each of 100 cord blood samples collected blindly from "normosomic" live births. There was a mean percentage of 0.017% megakaryoblasts in 100 cord blood samples from normosomic infants. Flow cytometry proved to be a sensitive, rapid, and reproducible method for the quantification of megakaryoblasts. Less than 1% of circulating nucleated cells in the blood of newborn infants are megakaryoblasts, providing a comparison population for the authors' larger proposed incidence study.

Maternal cell microchimerism in newborn tissues

Objectives On the basis of reports of maternal cells being detected in the umbilical cord blood of newborn infants, we tested the hypothesis that maternal cells can migrate out of the circulation into newborn tissues. Study design We studied autopsy material from 4 newborn infants who never received a blood transfusion and died during the first week of life. The study subjects' diagnoses were trisomy 21 with nonimmune hydrops, 46,XY, 4q+ with multiple congenital anomalies, Potter syndrome, and congenital ichthyosis. Fluorescence in situ hybridization analysis with X and Y chromosome–specific probes was performed on sections of paraffin-embedded tissue, including liver, spleen, thymus, thyroid, and skin. Results Female cells, as defined by the presence of intact nuclei with two X chromosome signals, were detected in multiple tissue types from all 4 male neonates. The number of female cells varied from 3 to 45 per slide. Conclusions Maternal cells enter the fetal circulation and are capable of migration to fetal and neonatal organs. This is of importance with regard to potential consequences of umbilical cord blood transplantation and postnatal development of autoimmune disease. (J Pediatr 2003;142:31-5)

Prevention of vitamin K deficiency bleeding in newborns.

Newborn babies are born vitamin K deficient; however, the deficiency is not sufficiently severe to cause a vitamin K deficiency coagulopathy and haemorrhagic disease of the newborn (HDN). Severe vitamin K deficiency can develop quickly in breast-fed newborns and can result in the appearance of classic HDN during the first week of life or late HDN during the first 2 months of life. Both forms of the disease can be severe, causing brain damage and death. Classic and late HDN are prevented by the intramuscular administration of vitamin K at birth. Oral prophylaxis prevents classic HDN but is ineffective in preventing late HDN. Despite proven effectiveness of intramuscular vitamin K prophylaxis there have been concerns about the need for, and safety of, this therapy. This review provides evidence that there is need for intramuscular vitamin K prophylaxis for all babies in order to eradicate haemorrhagic disease of the newborn and concludes that there is no evidence that this therapy is harmful.

Transfatty acids (TFAs) in cord blood of newborn infants and their concentration in mother's adipose tissue reflecting TFA consumption in France.† 1357

Recent studies suggests that dietary TFAs at relative high levels increase the risk of coronary heart disease. Another adverse effect of dietary TFAs is the suppression of the metabolism of linoleic acid (18:2n-6) and consequently the increased requirement for essential fatty acid (EFA). Exposure to TFAs during the fetal life may impair the growth of newborns babies. The aim of this study was to verify if circulating levels of TFA in foetuses are the reflection of TFA consumption in France. We measured by Capillary Gaz Chromatogaphy (CPsil 88-50mx0,25) all TFA isomers in plasma cord blood (PCB, n=15) or adipose tissue (AT) of pregnant women (PW, n=16) vs non-pregnant women (NPW, n=14).TFA deposition in adipose tissue was not affected by pregnancy, suggesting that consumption remains unchanged during gravide state. Because TFAs cannot be synthesized by human tissues, our results confirm the placental transfer of TFAs to foetuses. This is supported by the lower PCB-TFAs (0.75% vs 1.66%) founded our study compared with others reporting higher TFA consumption. TFA consumption remains a potential risk for the foetus since, even at a low consumption level, we demonstrated TFA placental transfer, particularly for oleic and linoleic acids' transisomers.Table

Enhancement in vitro of the low interferon-gamma production of leukocytes from human newborn infants.

Interferon-gamma (IFN-gamma), a lymphokine produced by lymphocytes with the help of monocytes, is essential for host resistance to intracellular pathogens. Leukocytes from normal term newborn infants cannot produce IFN-gamma in vitro in response to stimulation by antigen or mitogens in vitro or in vivo. We investigated the production of IFN-gamma in vitro using endotoxin from Salmonella typhimurium as a stimulus. In contrast to those from adults, mononuclear cells derived from the cord blood of newborn infants did not produce IFN-gamma in response to this endotoxin. We investigated the contribution of the functional immaturity of cord blood monocytes to this relative inability to produce IFN-gamma. Aging of the monocytes for 2 weeks in vitro or treatment of freshly isolated cord blood monocytes with conditioned medium (from cultures of mononuclear cells from healthy adults) greatly enhanced IFN-gamma production stimulated by endotoxin. Furthermore, recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF), macrophage colony-stimulating factor (M-CSF), or IFN-gamma was able to substitute in part for the conditioned medium from adult cells. Thus correction of the functional immaturity of monocytes derived from newborn infants can result in enhanced production of IFN-gamma in vitro.

Creatine phosphokinase isoenzyme activity in umbilical artery, umbilical vein and capillary blood of newborn infants at term.

Serum levels of creatine phosphokinase isoenzyme pattern (CPK MM, MB, BB) were measured in cord blood and capillary blood samples of 20 healthy term infants. Total CPK activity was high but similar in all samples, the main source being derived from the CPK-MM fraction. The CPK-MB fraction was absent in cord blood. Moreover, CPK-BB activity was significantly higher in capillary blood than in cord blood. These results suggest specific organ involvement in the production of CPK fractions.