Abstract
Background
The aim of this study is to investigate free carnitine (C0) and total acylcarnitine levels (AC) in preterm infants with BW < 1800 g and the relationship with neonatal and perinatal factors.
Methods
Ninety-three thousand two hundred and ninety-three newborns were screened between 2011 and 2013. Dried blood samples (DBS) were collected at 48–72 h, 14, and 30 days of age. We studied 92 consecutive preterm (BW < 1800 g) infants with low carnitine levels at 30 days of life (Group 1). As controls, we included the first 92 cases (BW < 1800 g) with normal carnitine levels (Group 2) and another 92 at or near-term newborns with BW > 1800 g (Group 3).
Results
Compared to 48–72 h levels, C0 and AC decreased at 14 and 30 days of life in Groups 1 and 2 (p < 0.001). In Group 2, the percentage of children with carnitine-free parenteral nutrition (PN) and BW < 1000 g was lower than in Group 1 (p < 0.001). Only in Group 2 did C0 increase at 30 days (p < 0.001). The multivariate regression analysis confirmed the influence of body weight and type of nutrition on C0 and AC.
Conclusion
Body weight and type of nutrition influenced the carnitine longitudinal pattern.
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Contributions
A.C., F.B. and B.R. conceived the study. B.R., I.B. and R.O. collected the data. F.R. performed the biochemical analyses. F.B., A.C. and B.R. drafted the article, and all authors contributed substantially to its revision. A.C., F.B., R.R. and F.R. made substantial contributions to conception and design and, analysis and interpretation of data. F.B., B.R. and A.C. were responsible for drafting the article and/or revising it critically for important intellectual content. G.F., A.C. and A.P. gave final approval of the version to be published.
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Baronio, F., Righi, B., Righetti, F. et al. Carnitine longitudinal pattern in preterm infants <1800 g body weight: a case–control study. Pediatr Res 86, 646–650 (2019). https://doi.org/10.1038/s41390-019-0497-2
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DOI: https://doi.org/10.1038/s41390-019-0497-2
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