27 nov. 2009 ERITROPOIETINA – MARKER AL HIPOXIEI FETALE LA NOU-NASCUTUL CU RESTRICTIE DE CRESTERE ERITROPOIETINA – MARKER AL HIPOXIEI FETALE LA NOU-NASCUTUL CU RESTRICTIE DE CRESTERE INTRAUTERINA. CORELATII NEONATALE
Gabriela Zaharie*, Florin Stamatian**, Monica Popa*, Dan Ona**, Nadia Schmidt*, Toader Zaharie***, Liana Kudor-Szabadi*
* Catedra de Neonatologie, U.M.F. “Iuliu Hatieganu” Cluj-Napoca
** Catedra de Obstetrica ginecologie, U.M.F. “Iuliu Hatieganu” Cluj-Napoca
*** Departamentul de Anatomie Patologica, Spitalul Octavian Fodor , Cluj-Napoca
Rezumat
Obiective:Studiul isi propune determinarea valorii plasmatice a eritropoietinei la NN cu RCIU (IUGR) ca marker al hipoxiei intrauterine, si corelarea nivelului acesteia cu aparitia complicatiilor imediate (nevoia de resuscitare a NN, intensitatea reanimarii, existenta asfixiei neonatale) si tardive ( retinopatia prematuritatii(ROP), enterocolita ulcero-necrotica (EUN), bronhodisplazie pulmonara (BDP).
Material si metoda Lucarea reprezinta un studiu prospectiv, randomizat aleator asupra unui lot de 33 NN cu restrictie de crestere intrauterina care s-au internat in Sectia de Neonatalogie a Clincii Ginecologie I, Spitalul Clinic Judetean de Urgenta Cluj-Napoca, Romania in perioada martie 2007 – martie 2008. Lotul martor este reprezentat de 16 nou-nascuti la termen, sanatosi. S-au determinat: tipul de nastere, scorul Apgar, nevoia de resuscitare, parametrii Astrup patologie perinatala, sindromul postasfixie, Hb, Pentru statistica s-a folosit EpiInfo6
Rezultate: Lotul de studiu a fost reprezentat de NN cu RCIU avand VG de 33,45 ± 4,29 SS, si indicele ponderal a fost de 1,91 ± 0,37. Lotul martor a fost reprezentat de nn sanatosi avand VG = 39,0631 ± 1,18 SS si IP = 2,21 ± 0,24. Nevoia de resuscitare a fosr semnificativ mai ridicat ^n lotul de studiu. Scorul Apgar la 1 minut a fost semnificati scazut tn lotul de studiu 5.41±2.20 versus 9.42±1.08 grupul de control. Valoarea eritropoetinei plasmatice a fost mult mai crescut ^n grupul de studiu 56.49±7.80 versus 42.45±17.53 grupul de control.
Concluzii: Eritropoetina plasmatica reprezinta un marker al hipoxiei fetale. EPO nu poate fi corelat cu dezvoltarea uni patologii precoce sau tradive la nou nascutii hipotrofici.
Abstract – PLASMATIC ERYTHROPOIETIN-MARKER OF FETAL HYPOXIA AT THE INTRAUTERINE GROWTH RESTRICTION NEWBORN
Objectives The study aims to discuss the value of plasmatic erythropoietin at birth as marker of fetal hypoxia in intrauterine growth restriction neonates. We also want to establish the relationship between EPO and risk to develop early and late complications.
Material and methods It is a prospective study on 33 newborns with intrauterine growth restriction managed by Neonatology department of Obstetrics and Gynecology I Clinic from Cluj and a control group of 16 healthy term newborns. Prenatal factors assessed: birth type, Apgar score, Astrup parameters, perinatal pathology, postasphyxia syndrome, hemoglobin, plasmatic erythropoietin. Statistic used EpiInfo6.
Results The study group was composed of 33 newborns gestational age of 33.45±4.29 weeks and ponderal index 1.19±0.31. Resuscitation necessity was significantly higher in study group (p=0.00001). Apgar score at 1 minute was significantly lower in study group 5.41±2.20 versus 9.42±1.08 in control group. Plasmatic erythropoietin value was higher in study group 56.49±7.80 versus 42.45±17.53 in control group.EPO presents a negative correlation with pO2 (r=-0.21) in the newborns from pregnancies that were not followed. There is no relation between the value of erythropoietin at birth and the development of early or late pathology.
Conclusions Plasmatic erythropoietin is a marker for neonatal resuscitation and an indicator of fetal hypoxia. EPO can not be correlated with the development of early or late pathology in IUGR newborn
Key words: erythropoetin, postnatal marker, growth restriction neonates