title: Plasma copeptin in preterm infants: a highly sensitive marker of fetal and neonatal stress.
abstract: BACKGROUND
  Copeptin is a stable by-product of arginine-vasopressin synthesis and reflects its secretion by the pituitary.
  
  
  OBJECTIVE
  The objective of the study was to investigate perinatal factors affecting copeptin concentrations in preterm infants at birth and at 3 d of life.
  
  
  METHODS
  This was a prospective cross-sectional study at two Swiss university hospitals.
  
  
  METHODS
  One hundred sixty-seven preterm infants were enrolled, 59 infants born between 24 and 31 wk gestational age, 50 infants between 32 and 34 wk, and 58 between 35 and 36 wk.
  
  
  METHODS
  Plasma copeptin concentrations, determined by a CT-proAVP-luminescence-immunoassay, were measured.
  
  
  RESULTS
  Copeptin at birth was significantly higher in preterm infants born vaginally [median (range) 366 (1-2900) pmol/liter, n = 43] than those born by cesarean section [6.9 (2-1580), n = 124]. In infants born after cesarean without prior labor (n = 66), estimated fetal weight less than the fifth percentile, suspect fetal heart rate, compromised placental perfusion, and chorioamnionitis were each associated with significantly elevated cord copeptin. Copeptin at 3 d of life was not associated with cord blood copeptin but inversely related to gestational age (Rs = -0.6, P < 0.001) and birth weight (Rs -0.612, P < 0.001). Day 3 copeptin increased alongside the level of mechanical respiratory support.
  
  
  CONCLUSIONS
  Copeptin is a highly sensitive marker of perinatal stress.
authors: Division of Neonatology, University Children's Hospital Basel, CH-4056 Basel, Switzerland.
authors: Jörg
authors: J
authors: Benzing
authors: Sven
authors: S
authors: Wellmann
authors: Federica
authors: F
authors: Achini
authors: Julia
authors: J
authors: Letzner
authors: Tilo
authors: T
authors: Burkhardt
authors: Ernst
authors: E
authors: Beinder
authors: Nils G
authors: NG
authors: Morgenthaler
authors: Ulrike
authors: U
authors: Haagen
authors: Hans Ulrich
authors: HU
authors: Bucher
authors: Christoph
authors: C
authors: Bührer
authors: Olav
authors: O
authors: Lapaire
authors: Gabor
authors: G
authors: Szinnai
mesh_terms: D015415:Biomarkers / Q000097:blood; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D007118:Immunoassay; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013312:Stress, Physiological / Q000502:physiology*
chemical_list: D015415:Biomarkers; D006020:Glycopeptides; C048197:copeptins