I. ?tucin Gantar, J. Babnik, M. Derganc
Role of surfactant inhibitors in amniotic fluid in respiratory distress syndrome
Aim. In vitro studies and animal experiments have provided
evidence that albumin, bilirubin, meconium and inflammatory
mediators act as surfactant inhibitors. The
aim of this research was to establish whether their elevated
concentrations in gastric aspirates, as representative
samples of amniotic fluid, could contribute to the development
of respiratory distress syndrome (RDS) in
preterm infants.
Methods. Infants born before the 35th week of gestation
between 1 March 1996 and 1 April 1997 were included.
They were divided into two groups: the RDS and non
RDS group. Gastric aspirates, taken immediately after
birth, were used for biochemical measurements of albumin,
bilirubin, meconium and E-?1-PI concentrations.
Results. Sixty-one preterm infants were enrolled: 23 in
the RDS group. The concentrations of albumin, bilirubin
and meconium in gastric aspirates were higher in the
RDS group (p < 0.01, p = 0.01 and p = 0.02, respectively).
The E-?1-PI concentration showed no significant difference
between the two groups. Logistic regression analysis
showed that a markedly increased risk of RDS was
only represented by albumin concentrations of over
1.6 mmol/l and gestational age of under 31 weeks.
Conclusion. Our observations indicate that increased
levels of albumin in the gastric aspirate, taken immediately
after birth, may contribute to the development of
RDS in preterm infants. Despite the established inhibitory
effects of bilirubin, meconium and inflammatory mediators
in vitro, we could not confirm their influence on
the development of RDS.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 30, 09/2002
Pages: 416 - 422
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