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Pediatric Surgery International
Published in: Pediatric Surgery International 6/2019

01-06-2019 | Neonatal Screening | Original Article

Use of serum citrulline concentrations from routine newborn screen as a biomarker for necrotizing enterocolitis

Authors: Sharmila Babu, Malavika Prasad, Malki Miller, Mark Morrissey, Alok Bhutada, Mary Rojas, Shantanu Rastogi

Published in: Pediatric Surgery International | Issue 6/2019

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Abstract

Purpose

Necrotizing enterocolitis (NEC), a leading cause of mortality and morbidity in preterm neonates, lacks a reliable biomarker. Citrulline is primarily produced by enterocytes and correlates with intestinal function. Serum citrulline concentration (CIT) is routinely measured in routine newborn screening (NBS). The purpose of the study is to test if CIT from NBS may predict the occurrence of NEC and whether it correlates with the time to full feeds (TTFF) and length of stay (LOS), serving as a biomarker of NEC and intestinal health.

Methods

In a retrospective case control study conducted on neonates with gestational age of 26–32 weeks, we compared CIT levels between cases (neonates with NEC) and controls (next-born neonate). NBS was collected within first 24 h, at day 5 and when the neonates achieved full feeds and were compared using non-parametric tests.

Results

There was no difference in CIT between the controls and cases on day 1 [11.42 (7.42–14.84 vs. 11.93 (6.85–18.8) µmol/L, p = 0.55], on day 5 [11.99 (7.99–16.55) vs. 13.70 (7.42–26.83) µmol/L, p = 0.05], or at full feeds [14.86 (6.85–25.69) vs. 15.7 (7.42–26.26) µmol/L, p = 0.87]. CIT on day 1 did not correlate with TTFF (r = 0.08, p = 0.53) or LOS (r = 0.23, p = 0.06), respectively).

Conclusions

CIT from routine NBS does not serve as a biomarker to predict NEC in preterm neonates.
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Metadata
Title
Use of serum citrulline concentrations from routine newborn screen as a biomarker for necrotizing enterocolitis
Authors
Sharmila Babu
Malavika Prasad
Malki Miller
Mark Morrissey
Alok Bhutada
Mary Rojas
Shantanu Rastogi
Publication date
01-06-2019
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 6/2019
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-019-04470-9

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