Immediate Postnatal Serum Tumor Necrosis Factor-Alpha Concentration and the Development of Bronchopulmonary Dysplasia.

Lee,  Jin A; Kim,  Beyong Il; Lim,  In Suk; Choi,  Chang Won; Kim,  Ee Kyung; Kim,  Han Suk; Choi,  Jung Hwan

Original Article

Journal of the Korean Society of Neonatology 2007;14(1):30-38.
Published online May 1, 2007.

Immediate Postnatal Serum Tumor Necrosis Factor-Alpha Concentration and the Development of Bronchopulmonary Dysplasia.

Jin A Lee, Beyong Il Kim, In Suk Lim, Chang Won Choi, Ee Kyung Kim, Han Suk Kim, Jung Hwan Choi

¹Department of Pediatrics, Seoul National Universitiy Boramae Hospital, Korea.
²Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. beyil@snu.ac.kr

Immediate Postnatal Serum Tumor Necrosis Factor-Alpha Concentration and the Development of Bronchopulmonary Dysplasia

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Abstract

PURPOSE
We tested the hypothesis that preterm infants who develop bronchopulmonary dysplasia (BPD) have higher concentration of serum tumor necrosis factor-alpha (TNF-alpha) within 8 hours after birth than those who do not.
METHODS
Serum and tracheal aspirate (TA) TNF-alpha concentrations were measured by enzyme-linked immunosorbent assay in the thirty-four preterm infants born before 32 weeks of gestation. Multiple logistic regression analysis was done.
RESULTS
Median concentrations of both serum and TA TNF-alpha were higher in BPD group than in non BPD group [serum TNF-alpha, 214.52 pg/mL (84.20-244.20) versus 100.07 pg/mL (78.43-225.52), P=0.037],[TA TNF-alpha, 13.12 pg/mL (10.43-64.67) versus 11.58 pg/ mL (9.76-58.53), P=0.038]. After making adjustments for the effects of gestational age at birth, 5 minute Apgar score less than 7 and histologic chorioamnionitis, only serum TNF-alpha concentration was independently significant [P=0.045 Odds ratio, 1.381 95% confidence interval, 1.007-1.895]. The diagnostic indices of TNF-alpha (cutoff, 97.1 pg/mL) as a predictor of development of BPD were: sensitivity of 85.7%, specificity of 38.5%, positive predictive value of 69.2%, negative predictive value of 62.5% (P=0.037).
CONCLUSION
Increased serum TNF-alpha concentration within 8 hours after birth may be a significant risk factor of later development of BPD.

Key Words: Bronchopulmonary dysplasia; Tumor necrosis factor-alpha; Risk factor