Systemic Inflammation in the First 2 Weeks After Birth as a Determinant of Physical Growth Outcomes in Hospitalized Infants With Extremely Low Gestational Age

Mandy B Belfort, Sara E Ramel, Camilia R Martin, Raina Fichorova, Karl C K Kuban, Timothy Heeren, Rebecca C Fry, T Michael O’Shea

J Pediatr. 2021 Sep 8:S0022-3476(21)00879-9. doi: 10.1016/j.jpeds.2021.09.006. Epub ahead of print. PMID: 34508750.

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The goal of this study was to examine associations of systemic inflammation with growth outcomes at neonatal intensive care unit (NICU) discharge/transfer among infants with extremely low gestational ages. Infants with CRP elevation on day 7 had lower weights at discharge/transfer (-0.17 z-scores, 95% CI -0.27, -0.06) than infants without CRP elevation; with similar results on day 14. Infants with CRP elevation on day 14 were also shorter (-0.21 length z-scores, 95% CI -0.38, -0.04), and had smaller head circumferences (-0.18 z-scores, 95% CI -0.33, -0.04) at discharge/transfer. IL-6 elevation on day 14 was associated with lower weight (-0.12, 95% CI -0.22, -0.02); IL-6 elevation on day 7 was associated with shorter length (-0.27, 95% CI -0.43, -0.12). TNF-∝ and IL-8 elevation on day 14 were associated with lower weight at discharge/transfer. Postnatal systemic inflammation may contribute to impaired nutrient accretion during a critical period in development in infants with extremely low gestational ages.