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5ICCN_027: The effect of phototherapy on oxidative stress and inflammatory response in newborns
5th International Conference on Clinical Neonatology – Selected conference abstracts / Early Human Development 90S2 (2014) S61–S79
rate of group B was obviously higher than that of group A (83% vs. 40%). Compared with traditional operation, the external drainage by inserting catheter into the intestine have the advantages of shorter operative time and higher postoperative survival rate, and could be used for the treatment of NEC which have too extensive lesions to be decided the resection range. 5ICCN_026 The IL-6, IL-18 and hsCRP levels of the newborn infants with hypoxic ischemic encephalopathy E. Unlu, O. Akbas, N. Guzo˘ ¨ glu, D. Aliefendioglu. Paediatric Dept., University Hospital of Kirikkale, Kirikkale, Turkey Keywords: Il-6; IL-18; hsCRP; Hypoxic ischemic encephalopathy Hypoxic ischemic encephalopathy (HIE), despite advances in diagnosis and treatment, is still a major problem which leads to increased morbidity and mortality. Previous studies suggested that inflammatory cycle induced by hypoxia and ischemia play a role in the pathogenesis of HIE. In this study we investigated the relationship between HIE and inflammatory response by measuring IL-6, IL-18 and hsCRP levels in newborn infants with HIE. All term infants who have diagnosed HIE, delivered in our institute between study period were included in the study. Infants were classificated to stage I, stage II and stage III according to clinical findings (Sarnat & Sarnat classification were used). IL-6, IL-18 and hsCRP levels were determined in blood samples; in the first 24 hours (early period), and 48–72 hours (late period) respectively. 30 patients were included in the study. We found that IL-6 levels were decreased and IL-18 and hsCRP were increased in the late period. Increased levels of IL-18 and hsCRP defined as statistically significant (p < 0.01, p < 0.05 respectively). Patients who died had higher levels of IL-18 in the late period. High serum IL-18 and hsCRP levels in the late period are associated with advanced stages of HIE. 5ICCN_027 The effect of phototherapy on oxidative stress and inflammatory response in newborns G. Agırtas, O. Akbas, N. Guzo˘ ¨ glu, D. Aliefendioglu. Paediatric Dept., University Hospital of Kirikkale, Kirikkale, Turkey Keywords: Hyperbilirubinemia; Phototherapy; Oxidative stress; Inflammatory response Oxidative stress caused by photodynamic reactions in phototherapy is the reason of many important diseases in newborns and phototherapy changes the cytokine production that lead to different effects in the immune system. In this study, the effects of light-emitting diode (LED) phototherapy and conventional phototherapy on oxidative stress and inflammatory response were investigated in hyperbilirubinemic newborns. Thirty term newborns that were recieving phototherapy for indirect hyperbilirunemia (as study group) and 30 term healthy newborns (as control group) were enrolled to the study. In the study group, 15 newborns recieved conventional phototherapy and 15 newborns received LED phototherapy. In the control group, blood was taken once during the first 5 days of life; in the study group, blood was taken before phototherapy, 24th hour during phototherapy and 24 hours after phototherapy was stopped. The blood was analysed for malonaldehyde (MDA), total oxidative stress (TOS), total antioxidant capacity (TAC), TNF-a, IL-6 and IL-8. There were no significant differences for MDA and TAC in the conventional phototherapy group before and after phototherapy.
S75
However, TOS levels were significantly higher during and after phototherapy when compared with before phototherapy. In the same group, IL-8 levels were significantly higher during phototherapy when compared to after phototherapy. IL-6 and TNF-a levels produced no such different results before and after phototherapy. When the LED phototherapy group was analysed, no differences were found in oxidative stress and inflammatory response parameters. In this study, LED phototherapy was found to have no effects on antioxidant defence systems and inflammatory response; whereas conventional phototherapy increased oxidative stress and had effects in some steps of inflammatory response. 5ICCN_028 Multicentric study on prevention of perinatal group B streptococcal disease in 12 hospitals of Lazio (Italy) R. Pedicino1 , M.C. De Nardo1 , V. Pisani1 , A.A. Zuppa2 , R. Riccardi2 , M. Bedetta3 , K. Bressan3 , A. Casati4 , F. Palmesi5 , A. Castronovo6 , L. Ligi7 , T. Perrone8 , S. Laurenzi9 , M. Gente10 , M. Bonci11 , I. Stolfi12 , F. Natale1 , M. De Curtis1 . 1Neonatology and NICU, Policlinico Umberto I, Roma, Italy; 2 Neonatology and NICU, Policlinico Gemelli, Roma, Italy; 3 Neonatology and NICU, Policlinico Casilino, Roma, Italy; 4 Neonatology and NICU, Ospedale Belcolle, Viterbo, Italy; 5 Neonatology and NICU, Ospedale Spaziani, Frosinone, Italy; 6 Neonatology and NICU, Ospedale S. Eugenio, Roma, Italy; 7 Neonatology and NICU, Ospedale S. Filippo Neri, Roma, Italy; 8 Neonatology, Ospedale S. Spirito, Roma, Italy; 9 Neonatology, Ospedale S. Giovanni Evangelista, Tivoli, Italy; 10 Neonatology, Clinica Quisisana, Roma, Italy; 11 Neonatology, Ospedale G.B. Grassi, Ostia, Italy; 12 Neonatology, Clinica Mater Dei, Roma, Italy Keywords: Group B streptococcal disease (GBS); GBS colonization; Intrapartum antibiotics prophylaxis (IAP); Early onset sepsis. Background: Universal screening at 35–37 weeks’ gestation for maternal group B streptococcal (GBS) colonization and use of intrapartum antibiotic prophylaxis (IAP) has resulted in substantial reductions in the burden of early-onset GBS disease among newborns. Epidemiological data about execution of maternal screening and IAP, when necessary, in the majority of Italian regions are often unknown. We propose the results of a multicentric, prospective study obtained by 12 hospitals in Lazio (Italy). Objectives: The aim of the research is to obtain data about vaginal/rectal (V/R) swab culture screening and IAP administered in pregnant women for the prevention of early-onset neonatal GBS disease. Methods: We analyzed neonatal and maternal data of all infants born in the month of March 2014 in 12 hospitals in Lazio. Obstetrical data were collected about: (a) pregnant who performed V/R swab for finding GBS, (b) time and way of execution of swab, (c) results of cultures, (d) way of delivery, (e) mothers who received or did not receive IAP, (f) way of administration of IAP, (g) presence of risk factors for early onset neonatal sepsis (gestational age <37 weeks/Premature rupture of membranes (PROM) >18 hours/chorioamnionitis). Our reference were guidelines from CDC of 2010 for prevention of perinatal GBS disease. Results: We studied data of 1075 newborns. 976 (90%) infants were at term, 99 (10%) infants were preterm. Preterm infants: 51.5% (51/99) of mothers, who delivered prematurely, performed V/R swabs before or at delivery and 9% of these (9/51) had positive V/R swab for GBS. For 84 mothers was indicated IAP as recommended by CDC, but only 10 (12%) received it correctly. 74 (88%) mothers didn’t received it or received it incorrectly.
rate of group B was obviously higher than that of group A (83% vs. 40%). Compared with traditional operation, the external drainage by inserting catheter into the intestine have the advantages of shorter operative time and higher postoperative survival rate, and could be used for the treatment of NEC which have too extensive lesions to be decided the resection range. 5ICCN_026 The IL-6, IL-18 and hsCRP levels of the newborn infants with hypoxic ischemic encephalopathy E. Unlu, O. Akbas, N. Guzo˘ ¨ glu, D. Aliefendioglu. Paediatric Dept., University Hospital of Kirikkale, Kirikkale, Turkey Keywords: Il-6; IL-18; hsCRP; Hypoxic ischemic encephalopathy Hypoxic ischemic encephalopathy (HIE), despite advances in diagnosis and treatment, is still a major problem which leads to increased morbidity and mortality. Previous studies suggested that inflammatory cycle induced by hypoxia and ischemia play a role in the pathogenesis of HIE. In this study we investigated the relationship between HIE and inflammatory response by measuring IL-6, IL-18 and hsCRP levels in newborn infants with HIE. All term infants who have diagnosed HIE, delivered in our institute between study period were included in the study. Infants were classificated to stage I, stage II and stage III according to clinical findings (Sarnat & Sarnat classification were used). IL-6, IL-18 and hsCRP levels were determined in blood samples; in the first 24 hours (early period), and 48–72 hours (late period) respectively. 30 patients were included in the study. We found that IL-6 levels were decreased and IL-18 and hsCRP were increased in the late period. Increased levels of IL-18 and hsCRP defined as statistically significant (p < 0.01, p < 0.05 respectively). Patients who died had higher levels of IL-18 in the late period. High serum IL-18 and hsCRP levels in the late period are associated with advanced stages of HIE. 5ICCN_027 The effect of phototherapy on oxidative stress and inflammatory response in newborns G. Agırtas, O. Akbas, N. Guzo˘ ¨ glu, D. Aliefendioglu. Paediatric Dept., University Hospital of Kirikkale, Kirikkale, Turkey Keywords: Hyperbilirubinemia; Phototherapy; Oxidative stress; Inflammatory response Oxidative stress caused by photodynamic reactions in phototherapy is the reason of many important diseases in newborns and phototherapy changes the cytokine production that lead to different effects in the immune system. In this study, the effects of light-emitting diode (LED) phototherapy and conventional phototherapy on oxidative stress and inflammatory response were investigated in hyperbilirubinemic newborns. Thirty term newborns that were recieving phototherapy for indirect hyperbilirunemia (as study group) and 30 term healthy newborns (as control group) were enrolled to the study. In the study group, 15 newborns recieved conventional phototherapy and 15 newborns received LED phototherapy. In the control group, blood was taken once during the first 5 days of life; in the study group, blood was taken before phototherapy, 24th hour during phototherapy and 24 hours after phototherapy was stopped. The blood was analysed for malonaldehyde (MDA), total oxidative stress (TOS), total antioxidant capacity (TAC), TNF-a, IL-6 and IL-8. There were no significant differences for MDA and TAC in the conventional phototherapy group before and after phototherapy.
S75
However, TOS levels were significantly higher during and after phototherapy when compared with before phototherapy. In the same group, IL-8 levels were significantly higher during phototherapy when compared to after phototherapy. IL-6 and TNF-a levels produced no such different results before and after phototherapy. When the LED phototherapy group was analysed, no differences were found in oxidative stress and inflammatory response parameters. In this study, LED phototherapy was found to have no effects on antioxidant defence systems and inflammatory response; whereas conventional phototherapy increased oxidative stress and had effects in some steps of inflammatory response. 5ICCN_028 Multicentric study on prevention of perinatal group B streptococcal disease in 12 hospitals of Lazio (Italy) R. Pedicino1 , M.C. De Nardo1 , V. Pisani1 , A.A. Zuppa2 , R. Riccardi2 , M. Bedetta3 , K. Bressan3 , A. Casati4 , F. Palmesi5 , A. Castronovo6 , L. Ligi7 , T. Perrone8 , S. Laurenzi9 , M. Gente10 , M. Bonci11 , I. Stolfi12 , F. Natale1 , M. De Curtis1 . 1Neonatology and NICU, Policlinico Umberto I, Roma, Italy; 2 Neonatology and NICU, Policlinico Gemelli, Roma, Italy; 3 Neonatology and NICU, Policlinico Casilino, Roma, Italy; 4 Neonatology and NICU, Ospedale Belcolle, Viterbo, Italy; 5 Neonatology and NICU, Ospedale Spaziani, Frosinone, Italy; 6 Neonatology and NICU, Ospedale S. Eugenio, Roma, Italy; 7 Neonatology and NICU, Ospedale S. Filippo Neri, Roma, Italy; 8 Neonatology, Ospedale S. Spirito, Roma, Italy; 9 Neonatology, Ospedale S. Giovanni Evangelista, Tivoli, Italy; 10 Neonatology, Clinica Quisisana, Roma, Italy; 11 Neonatology, Ospedale G.B. Grassi, Ostia, Italy; 12 Neonatology, Clinica Mater Dei, Roma, Italy Keywords: Group B streptococcal disease (GBS); GBS colonization; Intrapartum antibiotics prophylaxis (IAP); Early onset sepsis. Background: Universal screening at 35–37 weeks’ gestation for maternal group B streptococcal (GBS) colonization and use of intrapartum antibiotic prophylaxis (IAP) has resulted in substantial reductions in the burden of early-onset GBS disease among newborns. Epidemiological data about execution of maternal screening and IAP, when necessary, in the majority of Italian regions are often unknown. We propose the results of a multicentric, prospective study obtained by 12 hospitals in Lazio (Italy). Objectives: The aim of the research is to obtain data about vaginal/rectal (V/R) swab culture screening and IAP administered in pregnant women for the prevention of early-onset neonatal GBS disease. Methods: We analyzed neonatal and maternal data of all infants born in the month of March 2014 in 12 hospitals in Lazio. Obstetrical data were collected about: (a) pregnant who performed V/R swab for finding GBS, (b) time and way of execution of swab, (c) results of cultures, (d) way of delivery, (e) mothers who received or did not receive IAP, (f) way of administration of IAP, (g) presence of risk factors for early onset neonatal sepsis (gestational age <37 weeks/Premature rupture of membranes (PROM) >18 hours/chorioamnionitis). Our reference were guidelines from CDC of 2010 for prevention of perinatal GBS disease. Results: We studied data of 1075 newborns. 976 (90%) infants were at term, 99 (10%) infants were preterm. Preterm infants: 51.5% (51/99) of mothers, who delivered prematurely, performed V/R swabs before or at delivery and 9% of these (9/51) had positive V/R swab for GBS. For 84 mothers was indicated IAP as recommended by CDC, but only 10 (12%) received it correctly. 74 (88%) mothers didn’t received it or received it incorrectly.