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Jarosz-Lesz A, Brzozowska A, Maruniak-Chudek I. Copeptin Concentrations in Plasma of Healthy Neonates in Relation to Water–Electrolyte Homeostasis in the Early Adaptation Period. CHILDREN 2022; 9:children9030443. [PMID: 35327814 PMCID: PMC8947540 DOI: 10.3390/children9030443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 11/16/2022]
Abstract
Copeptin (CTproAVP) is a stable by-product of arginine–vasopressin synthesis and reflects its secretion by the pituitary gland, considered as a potential new marker of dehydration. The objective of the study was to investigate CTproAVP measured after the first 48 h of postnatal life in relation to serum effective osmolality, urine osmolality, and vessels filling according to the following variables: delivery mode, postnatal weight loss, fluids administered intravenously to the mother, and fluids given orally to the neonate. A prospective observational study was conducted with 200 healthy term infants (53% male) enrolled. Serum CTproAVP concentrations were measured using the ELISA kit; haematocrit, urine osmolality, serum effective osmolality were assessed after 48 h of life. Sonographic measurements of inferior vena cava (IVC) and aorta (Ao) were performed and IVC/Ao ratios were calculated. No correlations were found between CTproAVP concentrations and both serum effective osmolality and urine osmolality. There was also no association between CTproAVP concentrations and vessel filling represented by IVC/Ao index at 48 h of life.
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Affiliation(s)
- Anna Jarosz-Lesz
- Neonatology Unit, The Guardian Angels Hospital of the Brothers Hospitallers of St. John of God in Katowice, 40-211 Katowice, Poland;
| | - Aniceta Brzozowska
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland;
| | - Iwona Maruniak-Chudek
- Department of Neonatology and Neonatal Intensive Care, Faculty of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
- Correspondence: ; Tel.: +48-32-207-1780; Fax: +48-32-207-1781
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Driano JE, Lteif AN, Creo AL. Vasopressin-Dependent Disorders: What Is New in Children? Pediatrics 2021; 147:peds.2020-022848. [PMID: 33795481 DOI: 10.1542/peds.2020-022848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/12/2021] [Indexed: 11/24/2022] Open
Abstract
Arginine vasopressin (AVP)-mediated osmoregulatory disorders, such as diabetes insipidus (DI) and syndrome of inappropriate secretion of antidiuretic hormone (SIADH) are common in the differential diagnosis for children with hypo- and hypernatremia and require timely recognition and treatment. DI is caused by a failure to concentrate urine secondary to impaired production of or response to AVP, resulting in hypernatremia. Newer methods of diagnosing DI include measuring copeptin levels; copeptin is AVP's chaperone protein and serves as a surrogate biomarker of AVP secretion. Intraoperative copeptin levels may also help predict the risk for developing DI after neurosurgical procedures. Copeptin levels hold diagnostic promise in other pediatric conditions, too. Recently, expanded genotype and phenotype correlations in inherited DI disorders have been described and may better predict the clinical course in affected children and infants. Similarly, newer formulations of synthetic AVP may improve pediatric DI treatment. In contrast to DI, SIADH, characterized by inappropriate AVP secretion, commonly leads to severe hyponatremia. Contemporary methods aid clinicians in distinguishing SIADH from other hyponatremic conditions, particularly cerebral salt wasting. Further research on the efficacy of therapies for pediatric SIADH is needed, although some adult treatments hold promise for pediatrics. Lastly, expansion of home point-of-care sodium testing may transform management of SIADH and DI in children. In this article, we review recent developments in the understanding of pathophysiology, diagnostic workup, and treatment of better outcomes and quality of life for children with these challenging disorders.
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Affiliation(s)
- Jane E Driano
- School of Medicine, Creighton University, Omaha, Nebraska; and
| | - Aida N Lteif
- Division of Pediatric Endocrinology and Metabolism, Mayo Clinic, Rochester, Minnesota
| | - Ana L Creo
- Division of Pediatric Endocrinology and Metabolism, Mayo Clinic, Rochester, Minnesota
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Li JY, Wang PH, Vitale SG, Chen SN, Marranzano M, Cianci A, Lin LT, Tsui KH. Pregnancy-induced hypertension is an independent risk factor for meconium aspiration syndrome: A retrospective population based cohort study. Taiwan J Obstet Gynecol 2019; 58:396-400. [PMID: 31122532 DOI: 10.1016/j.tjog.2018.11.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2018] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Meconium aspiration syndrome (MAS), possibly resulting from fetal hypoxia, is a respiratory distress disorder in the infant. Pregnancy-induced hypertension (PIH) can cause placental dysfunction and lead to fetal hypoxia, which may induce the development of MAS. Therefore, the aim of this study was to determine the association between PIH and MAS and to identify the predictive risk factors. MATERIALS AND METHODS This was a retrospective cohort study. We selected patients with newly diagnosed PIH and a matched cohort group from the Taiwan National Health Insurance Research Database (NHIRD), from January 1, 2000 till December 31, 2013. For each patient in the PIH cohort, 4 subjects without PIH, matched for age and year of delivery, were randomly selected as the comparison cohort. The incidence of meconium aspiration syndrome was assessed in both groups. RESULTS Among the 23.3 million individuals registered in the NHIRD, 29,013 patients with PIH and 116,052 matched controls were identified. Patients who experienced PIH had a higher incidence of MAS than did those without PIH. According to a multivariate analysis, PIH (odds ratio [OR] = 1.70, 95% confidence interval [CI] = 1.49-1.93, p < 0.0001) was independently associated with increased risk of MAS. Additionally, age ≥30 years (OR = 1.26, 95% CI = 1.12-1.42, p = 0.0001), nulliparity (OR = 1.13, 95% CI = 1.01-1.27, p = 0.0367) and patients with diabetes mellitus (OR = 3.09, 95% CI = 1.35-7.09, p = 0.0078) were also independent risk factors of MAS. CONCLUSION Patients with PIH obtained higher subsequent risk for the development of MAS than those without PIH. Besides, age ≥30 years, nulliparity and patients with diabetes mellitus are the independent risk factors of developing MAS.
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Affiliation(s)
- Ju-Yueh Li
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Peng-Hui Wang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan, ROC; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC
| | - Salvatore Giovanni Vitale
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - San-Nung Chen
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Marina Marranzano
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy
| | - Antonio Cianci
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Li-Te Lin
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Biological Science, National Sun Yat-sen University, Kaohsiung City, Taiwan.
| | - Kuan-Hao Tsui
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Pharmacy and Graduate Institute of Pharmaceutical Technology, Tajen University, Pingtung County, Taiwan.
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