The relationship of melatonin concentration in preterm infants and adverse outcomes in the late neonatal period.

IF 3.8 3区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Biochemia Medica Pub Date : 2023-02-15 DOI:10.11613/BM.2023.010706
Нalyna Pavlyshyn, Iryna Sarapuk, Kateryna Kozak
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Abstract

Introduction: The aim of research was to assess the melatonin concentrations in the early neonatal period as a predictor of adverse outcomes of late neonatal period in preterm infants and to estimate its optimal predictive cut-off values.

Materials and methods: A total of 115 preterm infants admitted to the neonatal intensive care unit were screened for eligibility, five did not meet the criteria, six parents declined the participation. So, a total of 104 preterm infants with gestational age 25-34 weeks were included in research. The concentration of melatonin in urine was determined by the Enzyme Immunoassay method (Human Melatonin Sulfate ELISA kit, Elabscience, China). The Mann-Whitney U-test and analysis of the receiver operating characteristic (ROC) curve were used in statistical analysis.

Results: Analysis of the ROC curves has revealed optimal cut-off values for urinary melatonin concentration to predict late outcomes. Melatonin concentration below 3.58 ng/ml with sensitivity of 72% can predict development of retinopathy of prematurity (ROP) (AUC = 0.73; 95% confidence intervals (CI) 0.61-0.86). Good diagnostic accuracy (AUC = 0.80; 95% CI 0.67-0.93) has been shown for bronchopulmonary dysplasia (BPD). The optimal cut-off value for melatonin concentration in BPD prediction is 3.71 ng/ml (sensitivity 80%, specificity 64%). Urinary melatonin concentration below 3.79 ng/ml can be associated with late-onset sepsis (AUC = 0.76; 95% CI 0.64-0.87; sensitivity 72%; specificity 62%). There were no significant associations between melatonin concentration and necrotizing enterocolitis (P = 0.912).

Conclusion: Urinary melatonin concentration below the certain cut-off values in the early neonatal period may serve as one of the predictors of adverse outcomes such as BPD, ROP, and late-onset sepsis in the late neonatal period in preterm infants.

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早产儿褪黑素浓度与新生儿后期不良结局的关系。
研究的目的是评估新生儿早期褪黑激素浓度作为早产儿新生儿晚期不良结局的预测因子,并估计其最佳预测临界值。材料与方法:对新生儿重症监护病房收治的115例早产儿进行资格筛选,其中5例不符合标准,6例家长拒绝参与。因此,共有104名胎龄为25-34周的早产儿被纳入研究。尿中褪黑素浓度采用酶免疫法测定(人硫酸褪黑素ELISA试剂盒,Elabscience,中国)。统计学分析采用Mann-Whitney u检验和受试者工作特征(ROC)曲线分析。结果:ROC曲线分析揭示了尿褪黑激素浓度预测晚期预后的最佳临界值。褪黑素浓度低于3.58 ng/ml,预测早产儿视网膜病变(ROP)的敏感性为72% (AUC = 0.73;95%置信区间(CI) 0.61-0.86)。诊断准确率高(AUC = 0.80;95% CI 0.67-0.93)被证实为支气管肺发育不良(BPD)。褪黑激素浓度预测BPD的最佳临界值为3.71 ng/ml(敏感性80%,特异性64%)。尿褪黑素浓度低于3.79 ng/ml可与晚发性脓毒症相关(AUC = 0.76;95% ci 0.64-0.87;灵敏度72%;特异性62%)。褪黑素浓度与坏死性小肠结肠炎无显著相关性(P = 0.912)。结论:新生儿早期尿褪黑素浓度低于一定临界值可作为早产儿新生儿晚期BPD、ROP、晚发性脓毒症等不良结局的预测因素之一。
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来源期刊
Biochemia Medica
Biochemia Medica 医学-医学实验技术
CiteScore
5.50
自引率
3.00%
发文量
70
审稿时长
>12 weeks
期刊介绍: Biochemia Medica is the official peer-reviewed journal of the Croatian Society of Medical Biochemistry and Laboratory Medicine. Journal provides a wide coverage of research in all aspects of clinical chemistry and laboratory medicine. Following categories fit into the scope of the Journal: general clinical chemistry, haematology and haemostasis, molecular diagnostics and endocrinology. Development, validation and verification of analytical techniques and methods applicable to clinical chemistry and laboratory medicine are welcome as well as studies dealing with laboratory organization, automation and quality control. Journal publishes on a regular basis educative preanalytical case reports (Preanalytical mysteries), articles dealing with applied biostatistics (Lessons in biostatistics) and research integrity (Research integrity corner).
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