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KMID : 0438520070140010030
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Journal of the Korean Society of Neonatology
2007 Volume.14 No. 1 p.30 ~ p.38
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Immediate Postnatal Serum Tumor Necrosis Factor-Alpha Concentration and the Development Of Bronchopulmonary Dysplasia
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Lee Jin-A
Chol Chang-Won
Kim Beyong-Il
Kim Ee-Kyung
Kim Han-Suk
Lim In-Seok
Choi Jung-Hwan
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Abstract
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Purpose: We tested the hypothesis that preterm infants who develop bronchopulmonary dysplasia (BPD) have higher concentration of serum tumor necrosis factor-alpha (TNF-α) within 8 hours after birth than those who do not.
Methods: Serum and tracheal aspirate (TA) TNF-α concentrations were measured by enzyme-linked immunosorbent assay in the thirty-four preterm infants born before 32 weeks of gestation. Multiple logistic regression analysis was done.
Results: Median concentrations of both serum and TA TNF-α were higher in BPD group than in non BPD group [serum TNF-α, 214.52 pg/mL (84.20-244.20) versus 100.07 pg/mL (78.43-225.52), P=0.037],[TA TNF-α, 13.12 pg/mL (10.43-64.67) versus 11.58 pg/ mL (9.76-58.53), P=0.038]. After making adjustments for the effects of gestational age at birth, 5 minute Apgar score less than 7 and histologic chorioamnionitis, only serum TNF-α concentration was independently significant [P=0.045 Odds ratio, 1.381 95% confidence interval, 1.007-1.895]. The diagnostic indices of TNF-α (cutoff, 97.1 pg/mL) as a predictor of development of BPD were: sensitivity of 85.7%, specificity of 38.5%, positive predictive value of 69.2%, negative predictive value of 62.5% (P=0.037).
Conclusion: Increased serum TNF-α concentration within 8 hours after birth may be a significant risk factor of later development of BPD. (J Korean Soc Neonatol 2007; 14:30-38)
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KEYWORD
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Bronchopulmonary dysplasia, Tumor necrosis factor-alpha, Risk factor
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