title: Role of intrapartum hypoxia in carnitine nutritional status during the early neonatal period.
abstract: We analyze markers of carnitine insufficiency and deficiency, lysine (LYS) and methionine (MET), in 39 neonates with intrapartum hypoxia (selection criteria: umbilical artery pH <7.20, lactate >1.8 mmol/l and PaO2 <25 mm Hg), and in 35 healthy newborn infants (control group) in the early neonatal period (1-7 days of life). Free (FC), total (TC) carnitine and acylcarnitines (AC=short-chain+long-chain acylcarnitines) were measured using a radioisotopic micromethod; LYS and MET were determined by high-pressure liquid chromatography. AC and TC plasma concentrations and AC/FC ratio were higher while FC/TC ratio was lower in the hypoxic neonates than in the control group. Hypoxic newborn infants (59%) presented "carnitine deficiency" (FC/TC <0.7) and 60% of them "carnitine insufficiency" (AC/FC ratio >0.4) vs. 31% and 28%, respectively, for the neonates of the control group (p<0.05). In the healthy neonates group, MET correlated with FC/TC and the AC/FC ratio. FC, TC, AC, AC/FC and umbilical artery pH (pHua) were inversely correlated. FC/TC and MET correlated with pHua. We conclude that: (1) an important percentage of newborn infants with intrapartum hypoxia suffer carnitine deficiency and carnitine insufficiency in the early neonatal period, related to MET plasma levels; (2) the carnitine deficiency or insufficiency in the neonate is determined by the degree of intrapartum acidosis.
authors.affiliation: Department of Paediatrics, School of Medicine, University of Granada, Avda. de Madrid, 11, 18012, Granada, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Bayés
authors.forename: C
authors.initials: C
authors.lastname: Campoy
authors.forename: A
authors.initials: A
authors.lastname: Goicoechea
authors.forename: J M
authors.initials: JM
authors.lastname: Peinado
authors.forename: T
authors.initials: T
authors.lastname: Pedrosa
authors.forename: R M
authors.initials: RM
authors.lastname: Baena
authors.forename: C
authors.initials: C
authors.lastname: López
authors.forename: M
authors.initials: M
authors.lastname: Rivero
authors.forename: J A
authors.initials: JA
authors.lastname: Molina-Font
mesh_terms: D002331:Carnitine / Q000031:analogs & derivatives* / Q000097:blood / Q000172:deficiency*; D002851:Chromatography, High Pressure Liquid; D004952:Esters / Q000097:blood; D005311:Fetal Hypoxia / Q000097:blood / Q000150:complications*; D005865:Gestational Age; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D008239:Lysine / Q000097:blood; D008715:Methionine / Q000097:blood; D009752:Nutritional Status
chemical_list: D004952:Esters; C116917:acylcarnitine; D008715:Methionine; D008239:Lysine; D002331:Carnitine