Initial Metabolic Profiles Are Associated with 7-Day Survival among Infants Born at 22-25 Weeks of Gestation.
Initial Metabolic Profiles Are Associated with 7-Day Survival among Infants Born at 22-25 Weeks of Gestation.
复制标题
DOI：
10.1016/j.jpeds.2018.03.032
复制
发表时间：
2018-07
期刊：
影响因子：
--
通讯作者：
Jelliffe-Pawlowski LL
中科院分区：
文献类型：
--
作者：
Oltman SP;Rogers EE;Baer RJ;Anderson JG;Steurer MA;Pantell MS;Partridge JC;Rand L;Ryckman KK;Jelliffe-Pawlowski LL
评估妊娠22 - 25周出生的婴儿早期代谢特征结合婴儿特征与7天后存活率之间的相关性。该巢式病例对照包括2005年至2011年加州妊娠22 - 25周的465例单胎活产。所有婴儿都有新生儿代谢筛查数据。数据包括关联的出生证明和母婴出院记录。死亡率来自相关的死亡证明和死亡出院信息。7天内的每例死亡与按胎龄和出生体重z评分分类的4例存活对照相匹配，留下93例病例和372例对照。解释变量和7天生存率之间的关联通过逐步logistic回归建模。纳入模型时考虑了婴儿特征、42种代谢物和12种代谢物比值。通过曲线下面积评估模型性能。最终模型包括1个特征和11个代谢产物。该模型证明代谢模式与婴儿存活率之间存在强相关性（曲线下面积[AUC] 0.885，95% CI 0.851 - 0.920）。此外，仅使用选定代谢物的模型（AUC 0.879，95% CI 0.841 - 0.916）的表现优于具有多种临床特征的模型（AUC 0.685，95% CI 0.627 - 0.742）。代谢组学的应用显著加强了极早产儿7天存活率的相关性。医生可能能够使用出生时的代谢谱来改善死亡风险，并为妊娠<26周出生的婴儿提供产后咨询。
To evaluate the association between early metabolic profiles combined with infant characteristics and survival past 7 days of age in infants born at 22-25 weeks of gestation. This nested case-control consisted of 465 singleton live births in California from 2005 to 2011 at 22-25 weeks of gestation. All infants had newborn metabolic screening data available. Data included linked birth certificate and mother and infant hospital discharge records. Mortality was derived from linked death certificates and death discharge information. Each death within 7 days was matched to 4 surviving controls by gestational age and birth weight z score category, leaving 93 cases and 372 controls. The association between explanatory variables and 7-day survival was modeled via stepwise logistic regression. Infant characteristics, 42 metabolites, and 12 metabolite ratios were considered for model inclusion. Model performance was assessed via area under the curve. The final model included 1 characteristic and 11 metabolites. The model demonstrated a strong association between metabolic patterns and infant survival (area under the curve [AUC] 0.885, 95% CI 0.851-0.920). Furthermore, a model with just the selected metabolites performed better (AUC 0.879, 95% CI 0.841-0.916) than a model with multiple clinical characteristics (AUC 0.685, 95% CI 0.627-0.742). Use of metabolomics significantly strengthens the association with 7-day survival in infants born extremely premature. Physicians may be able to use metabolic profiles at birth to refine mortality risks and inform postnatal counseling for infants born at <26 weeks of gestation.
登录
查看更多内容
影响因子：
2
作者：
Arzuaga, Bonnie H.;Meadow, William
通讯作者：
Meadow, William
影响因子：
2.8
作者：
Bennett, Michael J.
通讯作者：
Bennett, Michael J.
影响因子：
9.8
作者：
Jelliffe-Pawlowski, Laura L.;Norton, Mary E.;Currier, Robert J.
通讯作者：
Currier, Robert J.
影响因子：
7.2
作者：
Kyser, Kathy L.;Morriss, Frank H., Jr.;Dagle, John M.
通讯作者：
Dagle, John M.
DOI：
10.1016/j.ejogrb.2014.02.030
发表时间：
2014-05-01
影响因子：
2.6
作者：
Ravelli, Anita C. J.;Schaaf, Jelle M.;Abu-Hanna, Ameen
通讯作者：
Abu-Hanna, Ameen