Association of cord blood digitalis-like factor and necrotizing enterocolitis

Steven W. Graves*, Michael S. Esplin, Paula McGee, Dwight J. Rouse, Kenneth J. Leveno, Brian M. Mercer, Jay D. Iams, Ronald J. Wapner, Yoram Sorokin, John M. Thorp, Susan M. Ramin, Fergal D. Malone, Mary J. O'Sullivan, Alan M Peaceman, Gary D.V. Hankins, Donald J. Dudley, Steven N. Caritis

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective Endogenous digoxin-like factor (EDLF) has been linked to vasoconstriction, altered membrane transport, and apoptosis. Our objective was to determine whether increased EDLF in the cord sera of preterm infants was associated with an increased incidence of necrotizing enterocolitis (NEC). Study Design Cord sera from pregnant women enrolled in a randomized trial of MgSO4 for fetal neuroprotection were analyzed for EDLF using a red cell Rb+ uptake assay in which the inhibition of sodium pump-mediated Rb+ transport was used as a functional assay of EDLF. Specimens were assayed blinded to neonatal outcome. Cases (NEC, n = 25) and controls (neonates not developing stage 2 or 3 NEC, n = 24) were matched by study center and gestational age. None of the women had preeclampsia. Cases and controls were compared using the Wilcoxon test for continuous and the Fisher exact test for categorical variables. A conditional logistic regression analysis was used to assess the odds of case vs control by EDLF level. Results Cases and controls were not significantly different for gestational age, race, maternal steroid use, premature rupture of membranes, or MgSO4 treatment. In logistic models adjusted for treatment group, race, premature rupture of membranes, and gestational age, cord sera EDLF was significantly associated with development of NEC (P =.023). Conclusion These data demonstrated an association between cord sera EDLF and NEC.

Original languageEnglish (US)
Pages (from-to)328.e1-328.e5
JournalAmerican Journal of Obstetrics and Gynecology
Volume210
Issue number4
DOIs
StatePublished - Jan 1 2014

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Necrotizing Enterocolitis
Fetal Blood
Gestational Age
Serum
Membranes
Rupture
Logistic Models
Sodium-Potassium-Exchanging ATPase
Pre-Eclampsia
digoxin-like factors
Vasoconstriction
Premature Infants
Pregnant Women
Steroids
Regression Analysis
Mothers
Newborn Infant
Apoptosis
Incidence
Therapeutics

Keywords

  • cord blood
  • digitalis-like factor
  • necrotizing enterocolitis
  • pregnancy
  • sodium pump

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Graves, S. W., Esplin, M. S., McGee, P., Rouse, D. J., Leveno, K. J., Mercer, B. M., ... Caritis, S. N. (2014). Association of cord blood digitalis-like factor and necrotizing enterocolitis. American Journal of Obstetrics and Gynecology, 210(4), 328.e1-328.e5. https://doi.org/10.1016/j.ajog.2013.11.011
Graves, Steven W. ; Esplin, Michael S. ; McGee, Paula ; Rouse, Dwight J. ; Leveno, Kenneth J. ; Mercer, Brian M. ; Iams, Jay D. ; Wapner, Ronald J. ; Sorokin, Yoram ; Thorp, John M. ; Ramin, Susan M. ; Malone, Fergal D. ; O'Sullivan, Mary J. ; Peaceman, Alan M ; Hankins, Gary D.V. ; Dudley, Donald J. ; Caritis, Steven N. / Association of cord blood digitalis-like factor and necrotizing enterocolitis. In: American Journal of Obstetrics and Gynecology. 2014 ; Vol. 210, No. 4. pp. 328.e1-328.e5.
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abstract = "Objective Endogenous digoxin-like factor (EDLF) has been linked to vasoconstriction, altered membrane transport, and apoptosis. Our objective was to determine whether increased EDLF in the cord sera of preterm infants was associated with an increased incidence of necrotizing enterocolitis (NEC). Study Design Cord sera from pregnant women enrolled in a randomized trial of MgSO4 for fetal neuroprotection were analyzed for EDLF using a red cell Rb+ uptake assay in which the inhibition of sodium pump-mediated Rb+ transport was used as a functional assay of EDLF. Specimens were assayed blinded to neonatal outcome. Cases (NEC, n = 25) and controls (neonates not developing stage 2 or 3 NEC, n = 24) were matched by study center and gestational age. None of the women had preeclampsia. Cases and controls were compared using the Wilcoxon test for continuous and the Fisher exact test for categorical variables. A conditional logistic regression analysis was used to assess the odds of case vs control by EDLF level. Results Cases and controls were not significantly different for gestational age, race, maternal steroid use, premature rupture of membranes, or MgSO4 treatment. In logistic models adjusted for treatment group, race, premature rupture of membranes, and gestational age, cord sera EDLF was significantly associated with development of NEC (P =.023). Conclusion These data demonstrated an association between cord sera EDLF and NEC.",
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author = "Graves, {Steven W.} and Esplin, {Michael S.} and Paula McGee and Rouse, {Dwight J.} and Leveno, {Kenneth J.} and Mercer, {Brian M.} and Iams, {Jay D.} and Wapner, {Ronald J.} and Yoram Sorokin and Thorp, {John M.} and Ramin, {Susan M.} and Malone, {Fergal D.} and O'Sullivan, {Mary J.} and Peaceman, {Alan M} and Hankins, {Gary D.V.} and Dudley, {Donald J.} and Caritis, {Steven N.}",
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Graves, SW, Esplin, MS, McGee, P, Rouse, DJ, Leveno, KJ, Mercer, BM, Iams, JD, Wapner, RJ, Sorokin, Y, Thorp, JM, Ramin, SM, Malone, FD, O'Sullivan, MJ, Peaceman, AM, Hankins, GDV, Dudley, DJ & Caritis, SN 2014, 'Association of cord blood digitalis-like factor and necrotizing enterocolitis', American Journal of Obstetrics and Gynecology, vol. 210, no. 4, pp. 328.e1-328.e5. https://doi.org/10.1016/j.ajog.2013.11.011

Association of cord blood digitalis-like factor and necrotizing enterocolitis. / Graves, Steven W.; Esplin, Michael S.; McGee, Paula; Rouse, Dwight J.; Leveno, Kenneth J.; Mercer, Brian M.; Iams, Jay D.; Wapner, Ronald J.; Sorokin, Yoram; Thorp, John M.; Ramin, Susan M.; Malone, Fergal D.; O'Sullivan, Mary J.; Peaceman, Alan M; Hankins, Gary D.V.; Dudley, Donald J.; Caritis, Steven N.

In: American Journal of Obstetrics and Gynecology, Vol. 210, No. 4, 01.01.2014, p. 328.e1-328.e5.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association of cord blood digitalis-like factor and necrotizing enterocolitis

AU - Graves, Steven W.

AU - Esplin, Michael S.

AU - McGee, Paula

AU - Rouse, Dwight J.

AU - Leveno, Kenneth J.

AU - Mercer, Brian M.

AU - Iams, Jay D.

AU - Wapner, Ronald J.

AU - Sorokin, Yoram

AU - Thorp, John M.

AU - Ramin, Susan M.

AU - Malone, Fergal D.

AU - O'Sullivan, Mary J.

AU - Peaceman, Alan M

AU - Hankins, Gary D.V.

AU - Dudley, Donald J.

AU - Caritis, Steven N.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Objective Endogenous digoxin-like factor (EDLF) has been linked to vasoconstriction, altered membrane transport, and apoptosis. Our objective was to determine whether increased EDLF in the cord sera of preterm infants was associated with an increased incidence of necrotizing enterocolitis (NEC). Study Design Cord sera from pregnant women enrolled in a randomized trial of MgSO4 for fetal neuroprotection were analyzed for EDLF using a red cell Rb+ uptake assay in which the inhibition of sodium pump-mediated Rb+ transport was used as a functional assay of EDLF. Specimens were assayed blinded to neonatal outcome. Cases (NEC, n = 25) and controls (neonates not developing stage 2 or 3 NEC, n = 24) were matched by study center and gestational age. None of the women had preeclampsia. Cases and controls were compared using the Wilcoxon test for continuous and the Fisher exact test for categorical variables. A conditional logistic regression analysis was used to assess the odds of case vs control by EDLF level. Results Cases and controls were not significantly different for gestational age, race, maternal steroid use, premature rupture of membranes, or MgSO4 treatment. In logistic models adjusted for treatment group, race, premature rupture of membranes, and gestational age, cord sera EDLF was significantly associated with development of NEC (P =.023). Conclusion These data demonstrated an association between cord sera EDLF and NEC.

AB - Objective Endogenous digoxin-like factor (EDLF) has been linked to vasoconstriction, altered membrane transport, and apoptosis. Our objective was to determine whether increased EDLF in the cord sera of preterm infants was associated with an increased incidence of necrotizing enterocolitis (NEC). Study Design Cord sera from pregnant women enrolled in a randomized trial of MgSO4 for fetal neuroprotection were analyzed for EDLF using a red cell Rb+ uptake assay in which the inhibition of sodium pump-mediated Rb+ transport was used as a functional assay of EDLF. Specimens were assayed blinded to neonatal outcome. Cases (NEC, n = 25) and controls (neonates not developing stage 2 or 3 NEC, n = 24) were matched by study center and gestational age. None of the women had preeclampsia. Cases and controls were compared using the Wilcoxon test for continuous and the Fisher exact test for categorical variables. A conditional logistic regression analysis was used to assess the odds of case vs control by EDLF level. Results Cases and controls were not significantly different for gestational age, race, maternal steroid use, premature rupture of membranes, or MgSO4 treatment. In logistic models adjusted for treatment group, race, premature rupture of membranes, and gestational age, cord sera EDLF was significantly associated with development of NEC (P =.023). Conclusion These data demonstrated an association between cord sera EDLF and NEC.

KW - cord blood

KW - digitalis-like factor

KW - necrotizing enterocolitis

KW - pregnancy

KW - sodium pump

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