Association of Cord Blood Digitalis-Like Factor and Necrotizing Enterocolitis

Citation

Graves, Steven W.; Esplin, M. Sean; McGee, Paula L.; Rouse, Dwight J.; Leveno, Kenneth J.; Mercer, Brian M.; Iams, Jay D.; Wapner, Ronald J.; Sorokin, Yoram; & Thorp, John M., Jr., et al. (2014). Association of Cord Blood Digitalis-Like Factor and Necrotizing Enterocolitis. American Journal of Obstetrics & Gynecology, 210(4), 328.e1–5. PMCID: PMC4130335

Abstract

OBJECTIVE: Endogenous digoxin-like factor (EDLF) has been linked to vasoconstriction, altered membrane transport and apoptosis. Our objective was to determine whether increased EDLF in the cord sera of preterm infants was associated with an increased incidence of necrotizing enterocolitis (NEC).
METHODS: Cord sera from pregnant women enrolled in a randomized trial of MgSO4 for fetal neuroprotection were analyzed for EDLF using a red cell Rb+ uptake assay where inhibition of sodium pump-mediated Rb+ transport was used as a functional assay of EDLF. Specimens were assayed blinded to neonatal outcome. Cases (NEC, n=25) and controls (neonates not developing stage 2 or 3 NEC, n=24) were matched by study center and gestational age. None of the women had preeclampsia. Cases and controls were compared using the Wilcoxon test for continuous and the Fisher's exact test for categorical variables. Conditional logistic regression analysis was used to assess the odds of case versus control by EDLF level.
RESULTS: Cases and controls were not significantly different for gestational age (GA), race, maternal steroid use, premature rupture of membranes (PPROM) or MgSO4 treatment. In logistic models adjusted for treatment group, race, PPROM and GA, cord sera EDLF was significantly associated with development of NEC (p=0.023).
CONCLUSIONS: These data demonstrated an association between cord sera EDLF and NEC.

URL

http://dx.doi.org/10.1016/j.ajog.2013.11.011

Reference Type

Journal Article

Year Published

2014

Journal Title

American Journal of Obstetrics & Gynecology

Author(s)

Graves, Steven W.
Esplin, M. Sean
McGee, Paula L.
Rouse, Dwight J.
Leveno, Kenneth J.
Mercer, Brian M.
Iams, Jay D.
Wapner, Ronald J.
Sorokin, Yoram
Thorp, John M., Jr.
Ramin, Susan M.
Malone, Fergal D.
O'Sullivan, Mary Jo
Peaceman, Alan M.
Hankins, Gary D. V.
Dudley, Donald J.
Caritis, Steve N., for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network

PMCID

PMC4130335

ORCiD

Thorp - 0000-0002-9307-6690