title: Plasma midregional proadrenomedullin in newborn infants: impact of prematurity and perinatal infection.
abstract: BACKGROUND
  Adrenomedullin (ADM) is one of the strongest endogenous vasodilating hormones. Its stable by-product midregional-proADM (MR-proADM) is an established indicator of systemic infection and cardiovascular compromise in adult patients.
  
  
  METHODS
  A prospective cross-sectional study was performed to investigate the perinatal factors affecting MR-proADM plasma concentrations in 328 newborn infants with a gestational age (GA) between 24 and 41 wk.
  
  
  RESULTS
  Blood samples were obtained in 270 infants from umbilical veins (with additional 108 paired samples from umbilical arteries), and at 2-3 d of life in 183 infants. Paired venous and arterial umbilical cord MR-proADM concentrations were closely related (Spearman's rank order correlation coefficient (R(s)) = 0.825, P < 0.001). MR-proADM concentrations at birth and at 2-3 d were inversely related to GA (R(s) = -0.403 and R(s) = -0.541, respectively) and birth weight (BW; R(s) = -0.421 and R(s) = -0.530, respectively; all P < 0.001). On stepwise regression analysis, clinical chorioamnionitis and umbilical arterial blood base excess retained a significant impact on MR-proADM cord venous blood concentrations. At 2-3 d of life, histologic chorioamnionitis and GA at delivery were significantly associated with MR-proADM levels.
  
  
  CONCLUSIONS
  As compared with adults, MR-proADM concentrations are elevated in neonates, especially those born very preterm. Immaturity and infection, which both feature low systemic vascular resistance, are related to increased MR-proADM concentrations.
authors.affiliation: Division of Neonatology, University Hospital Zürich, Zürich, Switzerland.
authors.forename: Deborah
authors.initials: D
authors.lastname: Admaty
authors.forename: Jörg
authors.initials: J
authors.lastname: Benzing
authors.forename: Tilo
authors.initials: T
authors.lastname: Burkhardt
authors.forename: Olav
authors.initials: O
authors.lastname: Lapaire
authors.forename: Lukas
authors.initials: L
authors.lastname: Hegi
authors.forename: Gabor
authors.initials: G
authors.lastname: Szinnai
authors.forename: Nils G
authors.initials: NG
authors.lastname: Morgenthaler
authors.forename: Hans Ulrich
authors.initials: HU
authors.lastname: Bucher
authors.forename: Christoph
authors.initials: C
authors.lastname: Bührer
authors.forename: Sven
authors.initials: S
authors.lastname: Wellmann
mesh_terms: D053607:Adrenomedullin / Q000097:blood*; D001724:Birth Weight; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D007239:Infections / Q000097:blood*; D008297:Male; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D012044:Regression Analysis
chemical_list: D011498:Protein Precursors; C088633:proadrenomedullin; D053607:Adrenomedullin