Neonatal Serum Research Articles

Associations between total, free and bioavailable 25-hydroxyvitamin D forms with adiponectin and irisin in maternal-neonatal pairs at birth from Greece.

Apart from the well-established skeletal effects, vitamin D has been explored as a secretagogue influencing various adipokines, including adiponectin and irisin. Recent evidence suggests that specific forms of 25-Hydroxyvitamin D (25(OHD), such as free and bioavailable 25(OH)D, may provide more accurate measurements of vitamin D status. The relationship between vitamin D status and serum irisin and adiponectin concentrations remains largely unexplored, particularly during pregnancy. We analyzed data from 67 healthy maternal-neonatal pairs from Northern Greece at birth. Biochemical and hormonal tests were conducted on each maternal-neonatal pair. The vitamin D forms were estimated using validated mathematical models. Subsequently, regression analyses were conducted to determine the association between the vitamin D forms and adipokine levels. Bioavailable maternal 25(OH)D was inversely associated with neonatal irisin concentrations [β=-73.46 (-140.573 to -6.341), p=0.034]. No other associations were observed between maternal vitamin D status and neonatal adipokine concentrations. In conclusion, maternal bioavailable vitamin D concentrations are inversely associated with neonatal serum irisin concentrations, warranting further studies to evaluate the underlying mechanisms for this finding.

Relationship between the serum creatinine concentrations of preterm neonates within 24h of birth and their mothers before delivery.

Neonatal serum creatinine (n-sCr) concentrations during the first few days of life have been reported to correlate with the maternal serum Cr (m-sCr) concentrations. We aimed to derive a regression equation to describe the relationship between n-sCr within 24h of birth in preterm neonates and m-sCr before delivery, and to perform multiple regression analysis to identify factors related to n-sCr and the difference between n-sCr and m-sCr. We recruited preterm neonates who were treated at the University of the Ryukyus Hospital between March 2012 and October 2022. Patients with underlying diseases or conditions that might affect hemodynamics were excluded, as were patients whose n-sCr and m-sCr were not measured in pairs. A total of 278 cases were included in the analysis. The median (interquartile range) gestational age, birth weight, n-sCr, and m-sCr were 33.9weeks (32.0-35.1weeks), 1901g (1579-2284g), 0.55mg/dL (0.48-0.64mg/dL), and 0.47mg/dL (0.42-0.57mg/dL), respectively. The regression equation derived was n-sCr = 0.092 + 0.970 × m-sCr (R2 = 0.768, p < 0.001). The multiple regression analysis showed that m-sCr was the most potent influencer of n-sCr, and the ratio of placental weight to birth weight (PW/BW ratio) was the most potent influencer of the difference between n-sCr and m-sCr. We have obtained an approximate equation of n-sCr = 0.1 + m-sCr for preterm neonates. In addition, the high PW/BW ration may reduce the difference between n-sCr and m-sCr.

Maternal and neonatal umbilical cord serum levels of 25-hydroxy vitamin D among Sudanese women with normal pregnancy: a cross-sectional study

Maternal and neonatal umbilical cord serum levels of 25-hydroxy vitamin D among Sudanese women with normal pregnancy: a cross-sectional study

Antenatal neuroprotective magnesium sulfate in very preterm infants and its association with feeding intolerance.

Magnesium sulfate (MgSO4) treatment is widely used for fetal neuroprotection despite the controversy concerning the side effects. There is limited data regarding the impact of various cumulative maternal doses and neonatal serum magnesium (Mg) levels on short-term neonatal morbidity and mortality. We opted to carry out a study to determine the impact of neonatal serum Mg levels on neonatal outcomes. We conducted this prospective observational study between 2017 and 2021. Antenatal MgSO4 was used for a neuroprotective purpose only during the study period. Inborn preterm infants delivered between 23 and 31 6/7 weeks of gestation were enrolled consecutively. Babies who underwent advanced resuscitation in the delivery room, inotropic treatment due to hemodynamic instability in the first 7 days of life, >12 hours since the discontinuation of maternal MgSO4 treatment, severe anemia, and major congenital/chromosomal anomalies were excluded from the study. The subgroup of babies with serum Mg level at the sixth hour of life underwent an analysis. A neonatal Mg concentration of 2.5mg/dl was used to classify MgSO4-exposed patients into two groups (<2.5 mg/dl and ≥2.5 mg/dl). Another analysis was performed between babies whose mothers were exposed to MgSO4 and those not exposed. Finally, the groups' neonatal outcomes were compared. Of the 584 babies, 310 received antenatal MgSO4. The birth weights were significantly lower in the MgSO4 exposed group (1113 ± 361g vs. 1202 ± 388g, p=0.005). Antenatal corticosteroid usage and intrauterine growth restriction were also noted to be higher. The MgSO4 group was more likely to have bronchopulmonary dysplasia, prolonged invasive ventilation, necrotizing enterocolitis, delayed enteral nutrition, and feeding intolerance (p<0.05). MgSO4 treatment was shown as an independent risk factor for feeding intolerance when corrected for confounders (OR 2.13 95% CI 1.4-3.1, p=0.001). Furthermore, serum Mg level significantly correlated with feeding intolerance (r =0.21, p=0.002). This study highlighted the effect of MgSO4 treatment and the potential superiority of serum the Mg level as a predictor of immediate neonatal outcomes, particularly delayed enteral nutrition and feeding intolerance. Further studies are warranted to ascertain the optimal serum Mg concentration of preterm infants in early life to provide maximum benefit with minimal side effects.

OR04-05 Prenatal Phthalate Exposure Alters The Pattern Of Fetal And Neonatal Endocrine Puberty In A Sex-specific Manner

Abstract Disclosure: M.A. Bunnell: None. P. Lin: None. S. Zhou: None. C. Park: None. S. Wang: None. Q. Hu: None. B. Marzbanabbasabadi: None. J. Oh: None. B. Wang: None. M. Laws: None. E. Fletcher: None. Z. Liu: None. E. Joo: None. H. Qiao: None. J. Flaws: None. C. Ko: None. Endocrine puberties (EP) are sex-specific transient elevations of gonadotropins and testosterone (T) in males and estradiol (E2) in females. Fetal EP occurs mid-gestation, neonatal EP is stimulated by the clearance of maternal estrogen after birth, and finally, reproductive function arises during classical puberty. EPs are critical for normal development and the sexual dimorphism of reproductive and some somatic organs. Disrupted T or E2 levels during fetal or neonatal EP lead to reproductive abnormalities in adults. The endocrine disrupting effects of phthalates have been well-documented in humans and animal models. Prepubescent children are highly susceptible to phthalate toxicity. In utero, exposure to phthalates causes gender-specific reproductive abnormalities. In this study, we tested the working hypothesis that in utero exposure to phthalates alters T and E2 levels in fetal and newborn mice in a gender-specific manner. Pregnant CD-1 dams (n=5-6/treatment/time point) were orally administered an environmentally relevant phthalate mixture (20 μg/Kg/day) or vehicle daily from embryonic day (ED) 10.5 until birth. On ED16.5, and postnatal hours (h) 1, 3, and 6, fetal tissues and neonatal sera and tissues were sampled for hormonal assays. Fetal and neonatal gonads were collected for testicular T and ovarian E2 measurements. The amount of serum per embryo was insufficient for determining circulating hormone levels in the fetus. Hence, at ED16.5, hormonal content of the full-body (excluding gonads) was used to assess the impact of phthalate exposure. Hormone levels were quantified by ELISA. At ED16.5, full-body T level was lower in exposed females (2.93 vs. 12.23 pg/body in control, P&amp;lt;0.0001), but higher in exposed males (277 vs. 216 pg/body in control, P=0.022). However, there was no difference in fetal testicular T (871 vs. 1027 pg/2 testes in control, P=0.089), indicating that testicular steroidogenesis was unaltered. A rapid decline in serum T levels occurred in both newborn control (h1= 623 pg/mL, h6= 249 pg/mL, P=0.009) and exposed males (h1= 600 pg/mL, h6= 224 pg/mL, P=0.0015), but serum LH remained constant (Control: h1= 0.83 ng/mL, h6= 0.63 ng/mL, P=0.36; exposed: h1= 0.69 ng/mL, h6= 0.82 ng/mL, P=0.43). Phthalate exposure did not impact neonatal serum T or LH in males. However, at h6, exposed females had lower serum E2 than controls (0.7 vs. 8.51 pg/mL in control, P=0.001). This study found that prenatal phthalate exposure altered T and E2 levels of males and females distinctly, without disrupting LH secretion and gonadal steroidogenesis. The results indicate that T and E2 levels were likely disrupted by altered steroid clearance due to a sex-dependent impact on hepatic T and E2 metabolism, rather than pituitary or gonadal hormone production. In conclusion, prenatal exposure to a phthalate mixture alters the levels of T and E2 during fetal and neonatal EP in a gender-specific manner. Presentation: Thursday, June 15, 2023

THU307 Landscapes Of MaternalAnd Neonatal Bacterial And Metabolic SignaturesAnd Their Interaction In Gestational Diabetes Mellitus

Abstract Disclosure: L. Ding: None. J. Liu: None. X. Zhai: None. X. Xiao: None. Background: Gestational diabetes mellitus (GDM) is strongly correlated with considerable risks to both the mother and the developing fetus. Although evidence indicates an association between the altered gut microbiota and GDM, the microbial and metabolic mechanisms that link the metabolic state between mothers and offspring are unknown. This study aims to characterize the maternal and neonatal bacterial and metabolic signatures and their interaction in gestational diabetes mellitus. Methods: Sixty-six mothers (39 women with GDM and 27 normal pregnant women) and eighty-nine newborns (44 from GDM mothers and 45 from normal mothers) were included in this study. Using 16S rRNA gene sequencing and untargeted metabolomic methods, we determined the gut microbiota and serum metabolomics both for mothers and newborns. Results: We found that the microbial and metabolic signatures of GDM mothers and newborns were significantly different from those of the Control group (Ctr), respectively. Intriguingly, we identified 14 genera (Phyllobacterium, etc.) that exhibited identical alterations in mothers and newborns between groups. Among the overlapped differential metabolites in mothers and newborns, 23 (Glutamyl-methionine, etc.) showed consistent alterations between groups, while 19 (Cyclotetradecane, etc.) metabolites exhibited opposite alterations. Metabolic KEGG pathway analysis revealed that 6 pathways, including fatty acid metabolism, sphingolipid metabolism, TCA cycle, transsulfuration pathway, bile acid metabolism, and carnitine metabolism were both enriched in mothers and newborns. Significantly, correlation analysis revealed the notable association between pyroglutamic acid and maternal glucose level in Ctr group was disrupted in GDM group (Ctr: r = -0.46, p = 0.02; GDM: r = 0.04, p = 0.82). Simultaneously, pyroglutamic acid was significantly correlated with neonate serum high-density lipoprotein cholesterol level, which was disrupted in newborns of GDM mothers (Ctr: r = 0.33, p = 0.03; GDM: r = -0.05, p = 0.80). Conclusion: Altogether, we demonstrated that GDM could consistently alter the microbiota and serum metabolome in mothers and newborns, which is significantly associated with their metabolic state respectively. These findings indicate that serum metabolites serve as promising targets to intervene in metabolic transmission in GDM, which needs further validation. Presentation: Thursday, June 15, 2023

EP20.03: Risk factors and prediction model for high neonatal serum magnesium concentrations in prenatal maternal magnesium sulfate therapy

EP20.03: Risk factors and prediction model for high neonatal serum magnesium concentrations in prenatal maternal magnesium sulfate therapy

Does a Nonreassuring Fetal Heart Rate Pattern Impair Renal Function in Neonates Prenatally Diagnosed with Congenital Anomalies of the Kidneys and Urinary Tract?

This study aimed to determine the effect of nonreassuring fetal heart rate (NRFHR) patterns in labor on the postnatal renal function of neonates with a prenatal diagnosis of congenital anomalies of the kidney and urinary tract (CAKUT). A retrospective cohort study was conducted in a single tertiary referral center between 2012 and 2020. All cases with a prenatal diagnosis of CAKUT were extracted, and their fetal, maternal, obstetrical, and neonatal characteristics were analyzed. Cases of multiple gestations, preterm delivery, small for gestational age, major associated malformations or genetic aberrations, and prelabor acute obstetrical events were excluded from the analysis. The study group was comprised of patients who experienced NRFHR during labor. The control groups included (1) patients who had a trial of labor with a normal fetal heart rate pattern and (2) patients who delivered by elective cesarean section (CS). The primary outcome was abnormal serum creatinine levels in the perinatal period. For statistical purposes, the CAKUT cases were classified into a low and high estimated risk for an abnormal postnatal renal outcome. A subgroup analysis of the results was performed accordingly. Two hundred and fifty-six fetuses diagnosed prenatally with CAKUT comprised the study group. Among these, 214 women (83%) opted for a labor trial, while 42 (17%) chose elective CS. Within the labor trial group, 21/214 patients (9.8%) experienced NRFHR during labor. Analysis of maternal and fetal characteristics revealed no statistically significant disparities between the groups. NRFHR patterns were not associated with a deterioration in neonatal serum creatinine compared with those with normal fetal monitoring or those born by an elective CS. NRFHR patterns during labor and delivery did not impair neonatal renal function status in fetuses diagnosed prenatally with low- and high-risk CAKUT. Delivery can be managed according to standard obstetrical guidelines. · Kidneys affected by CAKUT commonly display renal dysplasia and a reduction in nephron mass.. · Low Apgar scores and asphyxia are recognized as risk factors for perinatal acute kidney injury.. · Lack of research on NRFHR impact on perinatal renal function in prenatally diagnosed CAKUT.. · NRFHR patterns during labor did not impair neonatal renal function status in prediagnosed fetuses..

Effects of copper, zinc, and manganese source and inclusion during late gestation on beef cow-calf performance, mineral transfer, and metabolism.

To determine effects of Cu, Zn, and Mn source and inclusion during late gestation, multiparous beef cows [n = 48; 649 ± 80 kg body weight (BW); 5.3 ± 0.5 body condition score (BCS)] were individually-fed hay and supplement to meet or exceed all nutrient recommendations except Cu, Zn, and Mn. From 91.2 ± 6.2 d pre-calving to 11.0 ± 3.2 d post-calving, cows received: no additional Cu, Zn, or Mn (control, CON), sulfate-based Cu, Zn, and Mn (inorganic, ITM) or metal methionine hydroxy analogue chelates (MMHAC) of Cu, Zn, and Mn at 133% recommendations, or a combination of inorganic and chelated Cu, Zn, and Mn (reduce and replace, RR) to meet 100% of recommendations. Data were analyzed with treatment and breeding group (and calf sex if P < 0.25 for offspring measures) as fixed effects, animal as experimental unit, and sampling time as a repeated effect for serum, plasma, and milk measures over time. Post-calving cow liver Cu was greater (P ≤ 0.07) in MMHAC compared with all other treatments. Calves born to RR had greater (P ≤ 0.05) liver Cu than ITM and CON, and MMHAC had greater (P = 0.06) liver Cu than CON. Liver Mn was less (P ≤ 0.08) for RR calves than all other treatments. Calf plasma Zn was maintained (P ≥ 0.15) from 0 to 48 h of age in ITM and MMHAC but decreased (P ≤ 0.03) in CON and RR. Gestational cow BW, BCS, and metabolites were not affected (P ≥ 0.13) by treatment, but gestational serum thiobarbituric acid reactive substances (TBARS) were greater (P = 0.01) for CON than MMHAC. Treatment did not affect (P ≥ 0.13) calf birth size, vigor, placental size and minerals, or transfer of passive immunity. Neonatal calf serum Ca was greater (P ≤ 0.05) for MMHAC than all other treatments; other calf serum chemistry and plasma cortisol were not affected (P ≥ 0.12). Pre-suckling colostrum yield, and lactose concentration and content, were greater (P ≤ 0.06) for MMHAC compared with ITM and RR. Colostral triglyceride and protein concentrations were greater (P ≤ 0.08) for RR than MMHAC and CON. Cow lactational BW and BCS, milk yield and composition, and pre-weaning calf BW and metabolism were not affected (P ≥ 0.13) by treatment. Lactational serum TBARS were greater (P = 0.04) for RR than CON at day 35 and greater (P ≤ 0.09) for MMHAC at day 60 than all other treatments. Source and inclusion of Cu, Zn, and Mn altered maternal and neonatal calf mineral status, but calf size and vigor at birth, passive transfer, and pre-weaning growth were not affected in this study.

Neonatal Serum Gentamicin Concentrations and Outcomes Following Maternal Once-Daily Gentamicin Dosing.

This study evaluated newborn gentamicin serum concentrations after birth and the effects on the newborn after extended interval gentamicin dosing in peripartum mothers. This was a single-center, retrospective chart review of neonates born to mothers that received peripartum once-daily gentamicin dosing of approximately 5 mg/kg within 12 hours of delivery. A gentamicin serum concentration was obtained immediately after birth in the newborn. The primary outcome was initial neonatal gentamicin serum concentration after birth. Several secondary outcomes were evaluated including nephrotoxicity and ototoxicity. A subgroup analysis comparing baseline demographics of mother-newborn dyads with birth neonatal serum concentrations of less than 2 mcg/mL versus 2 mcg/mL or greater was performed. A total of 32 mother-newborn dyads were included. Newborns had a median gestational age of 39.4 weeks and median birth weight of 3.4 kg. The mean initial gentamicin serum concentration was elevated at 3.1 ± 1.9 mcg/mL among all newborns. The median maternal dose based on actual body weight in newborns with gentamicin serum concentrations less than 2 mcg/mL was 3.5 (IQR, 3.3-4.8) mg/kg versus 4.8 (IQR, 4.3-5.2) mg/kg in those that had serum concentrations of 2 mcg/mL or greater (p = 0.025). All newborn gentamicin serum concentrations were less than 2 mcg/mL for maternal doses given less than 1 hour prior to delivery (n = 8). There were no significant differences in nephrotoxicity or ototoxicity. Peripartum once daily dosing of gentamicin administered between 1 to 12 hours of birth may lead to clinically significant serum concentrations in newborns.

Screening and Identification of Dominant B-cell Epitopes of Human Cytomegalovirus UL138 and Its Clinical Applications

Aim: To predict the dominant B-cell epitope of the human cytomegalovirus UL138 gene and to provide a new assay for its latent infection. Methods: Recombinant plasmids were constructed with the predicted dominant epitopes, induced to be expressed and immunized in mice as a way to identify peptide antigenicity, immunogenicity and human serum. Results: Five potentially dominant B-cell epitopes were obtained. The positive rate of detection was found to be significantly higher in neonatal, adult and mouse serum specimens than in human cytomegalovirus (HCMV) (IgG, IgM) and UL138 gene DNA and cDNA assays (p &lt; 0.05). Conclusion: The predicted dominant B-cell epitope is highly sensitive for the detection of human serum HCMV latent infection and can replace the traditional HCMV IgG assay.

Metabolomics Analysis Reveals the Potential Relationship Between Sow Colostrum and Neonatal Serum Metabolites in Different Pig Breeds.

Colostrum composition is an important indicator of newborn piglet survival and growth. However, limited information is available on the association between colostrum metabolites in sows and serum metabolites in neonates. Therefore, the present study aims to determine the metabolites in the colostrum of sows, in the serum of their offspring piglets, and mother-offspring metabolite correlations in different pig breeds. Colostrum and serum samples are collected from 30 sows and their piglets from three pig breeds (Taoyuan black, TB; Xiangcun black, XB; and Duroc) to analyze the targeted metabolomics. This study identifies 191 metabolites in the colostrum of sows, including fatty acids, amino acids, bile acids, carnitines, carbohydrates, and organic acids, and the concentrations of these metabolites are highest in the TB pigs. Metabolite profiles in sow colostrum and piglet serum differ among Duroc, TB, and XB pigs, and the matching metabolites are mainly enriched in the digestive system and transportation pathways. Furthermore, identification of the associations between metabolites in the colostrum of sows and their neonate sera suggests that metabolite compounds from colostrum are transported to suckling piglets. The present study findings deepen the understanding of the composition of sow colostrum metabolites and the transportation of metabolites from sow colostrum to piglets. The findings also provide insight regarding the development of dietary formulas that resemble the sow colostrum for newborn animals to maintain health and improve the early growth of offspring.

Risk factors associated with vitamin D deficiency in preterm neonates: a single-center step-wise regression analysis

BackgroundVitamin D deficiency is particularly concerning in pregnant women, leading to various health-related issues in mothers and their babies, especially those born prematurely, including neonatal skeletal and respiratory disorders. In addition, there have been several reports indicating the presence of multiple impactful factors in the development of vitamin D deficiency. Therefore, we aimed to evaluate the vitamin D level in very preterm and moderately preterm newborns and investigate its association with presumed influential factors.MethodsThis cross-sectional descriptive study was performed on 54 mothers and their preterm neonates with gestational ages less than 34 weeks at delivery (i.e., very preterm and moderately preterm). After the serum vitamin D levels were determined from samples obtained in the first 24 h after birth, the babies were divided into two groups based on the presence or absence of deficiency. The relationship between several factors and the neonatal serum vitamin D level was investigated separately and in a linear step-wise regression model.ResultsThe differences between the groups regarding maternal age, gestational age, neonate's gender, birth weight, and delivery method with neonatal vitamin D levels were not statistically significant. However, maternal vitamin D levels strongly correlated with neonatal vitamin D levels (P-value < 0.001, r = 0.636). The regression model also yielded a strong predictive capability (P-value < 0.001, Adjusted R2 = 0.606), with the maternal vitamin D level demonstrating a significant impact.ConclusionsLow vitamin D levels in pregnant mothers correlate with deficient levels in their preterm neonates. Therefore, as vitamin D deficiency significantly affects both the mother's and newborn's health, it is recommended that healthcare providers provide comprehensive plans for vitamin D supplementation during pregnancy.

Age specific differences in murine alveolar endothelial cells to pathological conditions

Abstract Neonatal pulmonary viral infections can have diverse outcomes ranging from bronchiolitis and pneumonia in RSV infection to more subdued response in SARS-CoV-2 infection. In this study, we investigated the responses of murine alveolar endothelial cells (MLEC) to neonate mice serum in presence of TLR agonists-treated macrophages, which can mimic SARS-Cov2 induced innate cell activation. We found that when poly I:C and ssRNA40 activated macrophages were cocultured with neonatal mice serum-treated MLECs, the expression of TNFα and IL-6 were significantly decreased. Moreover, macrophage co-culture leads to decreased ACE2 and VEGFR2 in adult MLECs, but macrophage co-culture increased ACE2 expression in neonatal MLECs under Poly I:C but not ssRNA40 stimulation. Addition of neonatal mice serum to MLECs increases the reactive oxygen species but downregulates multiple inflammatory signal pathways. Concurrently, the expression VE-cadherin and Shp2 was downregulated in neonatal mice serum exposed MLECs, which leads to compromised MLEC barrier integrity. Morphologically, neonatal mice serum, but not adult mice serum, triggered the lipid droplets formation and upregulated SR-BI and CD36 receptor expression in MLECs. Taken together, neonatal and adult MLECs differentially regulate cytokine-secretion from activated macrophages, and neonatal serum breaks the tight cell junction between MLECs by down regulating Shp2 and VE-Cadherin expression and induces the lipid droplets formation in MLECs through receptors SR-BI and CD36. The differences in neonatal and adult MLEC responses to pathologic conditions may reflect the age specific pulmonary manifestations to viral infections.

Maternal hypovitaminosis D presenting as late-onset hypocalcemic seizure in a term neonate: a case report

BackgroundVitamin D deficiency is a known morbidity among pregnant women. Maternal hypovitaminosis D results in poor fetal transplacental vitamin D accretion and decreased stores in the neonate. This in turn may lead to hypocalcemia in neonates, having presentations from being asymptomatic and tremors to hypocalcemic seizures. There are fewer case reports of hypocalcemic neonatal seizures as a result of maternal vitamin D deficiency.Case presentationA term male neonate developed multiple episodes of multifocal seizures on day six of life associated with hypocalcemia. He was also found to have hyperphosphatemia, raised alkaline phosphatase, and elevated parathormone levels with normal serum magnesium and renal function tests. Neonate and maternal serum vitamin D3 levels were also low. A diagnosis of late-onset hypocalcemic seizure secondary to maternal hypovitaminosis D was made and the baby made an uneventful recovery with parenteral calcium and oral vitamin D supplementation. On follow-up with therapy, the baby remained asymptomatic with normal serum calcium, phosphate, and vitamin D3 levels.ConclusionHypovitaminosis D must also be considered as a contributing factor for late-onset hypocalcemic seizure in neonates.

Selenium status in term neonates, according to birth weight and gestational age, in relation to maternal hypertensive pathology.

Pregnancy represents a state of increased oxidative stress and antioxidants, in which selenium (Se) plays a pivotal role, contribute to maintain the oxidative balance. If antioxidant defenses are depleted, placental function is disrupted, resulting in pregnancy complications, including pregnancy-induced hypertension (PIH). Little is known about fetal selenium status in concomitant relation to maternal PIH, gestational age (GA) and birthweight (BW). We examined over a 3-year period the serum (SeS) and urine selenium (SeU) status in term neonates from normotensive (nonPIH) and hypertensive (PIH) mothers as clinical markers of oxidative stress. In this retrospective observational study, 72 neonates with maternal PIH were matched for GA and BW to 72 neonates of normotensive mothers. Four groups were obtained, based on maternal PIH and BW relative to GA (appropriate-for-gestational-age-AGA, small-for-gestational-age-SGA): nonPIH-AGA (control group), nonPIH-SGA, PIH-AGA, and PIH-SGA. The results showed significant differences (p < 0.001) in selenium levels among the study groups: SeS - 44.85 ± 7.56 μg/L in nonPIH-AGA, 39.62 ± 11.42 μg/L in nonPIH-SGA, 40.01 ± 10.07 μg/L in PIH-AGA, and 25.39 ± 8.99 μg/L in PIH-SGA; SeU - 27.98 ± 7.99 μg/L in nonPIH-AGA, 22.85 ± 9.48 μg/L in nonPIH-SGA, 23.44 ± 6.73 μg/L in PIH-AGA, and 13.05 ± 5.86 μg/L in PIH-SGA. Selenium depletion was more common in neonates born from hypertensive mothers and those born small for gestational age. Though moderate in intensity, selenium levels were positively correlated with BW (0.319 for SeS, 0.397 for SeU) and negatively correlated with maternal systolic blood pressure (-0.313 for SeS, -0.324 for SeU). The main independent effects on SeS and SeU of each maternal blood pressure and birth weight turned out statistically significant. In interaction, a more pronounced effect was reached in PIH-SGA neonates. Selenium status seemed to reflect the negative impact that PIH exerts in neonates during intrauterine development. Clinical markers of selenium status could thus be of great value for tracking responses of individuals to selenium supplementation as part of health improvement and harm mitigation approaches.

TO STUDY THE EFFECTS OF DIFFERENT TIMING OF DELAYED CORD CLAMPING ALONG WITH MILKING ON HAEMATOLOGICAL PARAMETERS IN NEWBORNS - A RANDOMIZED CONTROL TRIAL

Objectives: Evaluation of the hematological parameter in newborn by delayed cord clamping at 60 s and at 180 s. Comparison of the improvement in hematological parameters, that is, hemoglobin and serum ferritin in newborn by both methods. Methods: This was randomized, controlled, and comparative study conducted during April 2021 to February 2022 at the Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur. The study included sample size of 60 cases (30 cases in each group). 60 cases were randomly allocated to either 60 s (Group A) or 180 s (Group B) groups of delayed cord clamping. The study included all singleton pregnant women &gt;34 weeks of gestational age. Results: Mean hemoglobin±standard deviation of neonate at birth for Group A was13.53±0.56 g/dL and for Group B it was 13.85±0.55 g/dL. Mean hemoglobin ± standard deviation at 6 month for Group A was 13.19±0.53 g/dL and for Group B was 13.53±0.55 g/dL. Mean serum ferritin±standard deviation of infant at for Group A was 12.46±0.45% and for Group B was 12.86±0.55%. Conclusion: Neonatal hemoglobin and serum ferritin were significantly higher in180 s delayed cord clamping as compared to 60 s delayed cord clamping group.

Low Serum Vascular Endothelial Growth Factor Level Predicts Adverse Outcomes in Neonates with Respiratory Distress Syndrome

Objective: Preterm neonates are susceptible to neonatal respiratory distress syndrome (NRDS). Lower levels of cord blood vascular endothelial growth factor (VEGF) are implicated in NRDS. This study aims to explore whether the serum VEGF level has prognostic values on neonates with respiratory distress syndrome (RDS). Methods: A total of 80 infants diagnosed with NRDS were enrolled, with 70 preterm neonates without NRDS as controls. Cord blood samples before treatment and venous blood samples after treatment were collected and clinical information was recorded. The serum VEGF level was measured using enzyme-linked immunosorbent assay kits. Receiver operating characteristic (ROC) curve was used to evaluate whether serum VEGF is a biomarker of NRDS. Newborns were followed up for 1 month to collect survival information. The influence of VEGF levels on overall survival was analyzed using the Kaplan-Meier method. The univariate and multivariate Cox regression models were adopted to assess the prognostic factor of NRDS. Results: VEGF level was decreased in sera of neonates with RDS. The area under the ROC curve of VEGF level in distinguishing neonates with RDS from neonates without RDS was 0.949, with a cutoff value of 39.72 (87.50% sensitivity, 87.14% specificity). Serum VEGF was a biomarker of NRDS. Neonates with RDS with high VEGF levels had longer periods of survival than those with low VEGF levels. NRDS grade and VEGF level were independent prognostic factors affecting the overall survival of neonates with RDS. Conclusion: Decreased serum VEGF level in RDS neonates can predict the poor prognosis of NRDS, and VEGF level might be an independent prognostic factor for the overall survival of RDS neonates. Clinical Trial Registration No. 201901A.

Effectiveness of Massage Therapy with and Without Oil on Neonatal Weight and Serum Triglycerides: A Randomized Clinical Trial

Background: Low birth weight among preterm neonates is a crucial public health problem worldwide. Objectives: The study aimed to assess if massage therapy and coconut oil application could affect weight gain in premature neonates. Method: A double-blind, randomized controlled trial (RCT) was conducted in neonatal intensive care units (NICU) of 2 educational hospitals affiliated with Shahid Beheshti University of Medical Sciences, Tehran, Iran, from September 2019 to April 2021. Massage therapy, alongside applying coconut oil to the skin for 5 days, versus massage therapy with tepid water, was considered an intervention. Demographic data, weight gain, and serum triglycerides (TG) levels were the outcomes. First, oil was tested on the baby’s wrist skin. If there was no skin reaction or side effects, massage therapy was started using fingertips in 3 steps, and each step lasted for 5 minutes. Results: The study included 94 neonates with a gestational age of fewer than 37 weeks who were randomly assigned to 3 groups: body massage with coconut oil group (n = 33), body massage without oil (n = 30), and control group (n = 31) who did not receive any intervention. Fifty-one cases (54.3%) were male. The mean gestational age of all patients was 32.5 ± 2.24 weeks (range of 27 to 36.6), birth weight was 1769.04 ± 472.8 grams (range of 800 to 2780 grams), serum triglycerides levels before and after intervention in all patients were 0.87 ± 0.43 and 1.14 ± 0.50 mmol/L respectively (or 77.04 ± 39.7 and 100.94 ± 44.7 mg/dL respectively) (P = 0.44). The 5-day average weight gains based on the groups included: coconut oil: 49.24 ± 94.32 grams, tepid water: 27.16 ± 65.79 grams, control: 26.29 ± 77.09 grams, P = 0.49. There were no statistically significant differences among all groups for weight gain and change in serum TG levels. Conclusions: Massage therapy, alongside applying coconut oil to the skin for 5 days, could not increase weight and serum TG levels in premature neonates. Further studies with long-term intervention and a larger sample size are recommended.

Relationship between maternal Vitamin D levels and neonatal Vitamin D levels with delayed neonatal hypocalcemia - A hospital-based observational study

Background: Vitamin D has important role in regulating various metabolic processes in the body including calcium metabolism. Fetuses and neonates are dependent on their mothers to get adequate supply of Vitamin D. Maintaining adequate maternal Vitamin D levels may be highly beneficial for their fetuses and the babies. Aims and Objectives: The aim of the study was to find a correlation, if any, between maternal Vitamin D status and neonatal Vitamin D levels and delayed neonatal hypocalcemia. Materials and Methods: Fifty mother infant pairs with neonatal late onset hypocalcemia were included in the study. Detailed clinical history along with simultaneous maternal and neonatal blood samples were taken for estimation of calcium, phosphorus, parathormone (intact), and Vitamin D levels. Results: Mean maternal and neonatal serum Vitamin D (25-OH Vitamin D) levels were 19.5±7.5 and 15±8.5, respectively. There was a statistically significant correlation between maternal and neonatal Vitamin D levels (P=0.001). There was also a direct correlation between low maternal Vitamin D levels and delayed hypocalcemia in neonates (P=0.048). Mean maternal and neonatal serum calcium levels were 9±1.5 mg/dl and 6.2±0.4 mg/dl, respectively. There was no significant statistical correlation between the two (P&gt;0.05). Conclusion: Maternal Vitamin D level appears to be an important determinant of neonatal Vitamin D and serum calcium levels.