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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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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.
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.
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).
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


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