Worse outcomes in preemies lacking haptoglobin who were exposed to inflammation in utero
WEDNESDAY, April 10, 2019 (HealthDay News) — The absence of haptoglobin (Hp) may be a marker of poor neonatal outcomes among preterm newborns exposed to in utero inflammation, according to a secondary analysis of a randomized controlled trial published online March 22 in EClinicalMedicine.
Catalin S. Buhimschi, M.D., from The Ohio State University in Columbus, and colleagues evaluated cord blood samples from 921 newborns of women at imminent risk for preterm delivery who were randomized to either placebo (471 newborns; birth gestational age [GA] median, 31 weeks) or magnesium sulphate (450 newborns; GA median, 31 weeks).
The researchers found that infant death by 1 year and/or cerebral palsy (CP) ≥2 years of corrected age occurred in 2.8 percent of offspring. Newborns were classified by cord blood Hp expression switch status and interleukin-6 levels in three predefined groups: inflammation-nonexposed (category 1; 47 percent), inflammation-exposed haptoglobinemic (category 2; 49 percent), and inflammation-exposed anhaptoglobinemic or hypohaptoglobinemic (category 3; 4 percent). Newborns in category 3 had increased odds of intraventricular hemorrhage (IVH) and/or death (adjusted odds ratio, 7.0) and of CP and/or death (adjusted odds ratio, 6.27) versus newborns in category 2. Adjusted odds ratios similar to inflammation-nonexposed newborns were seen among fetuses with ability to respond to inflammation by haptoglobinemia.
“The takeaway message of this study is that a simple test of cord blood after delivery could help doctors develop an individualized care plan for some at-risk newborns,” Buhimschi said in a statement.
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