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The influence of maternal disease on metabolites measured as part of newborn screening.

ABSTRACT: Measurements of neonatal metabolites are commonly used in newborn screening (NBS) programs to detect inborn errors of metabolism. Variation in these metabolites, particularly in infants born preterm (<37 weeks gestation), can result from multiple etiologies. We sought to evaluate the impact of maternal complications of pregnancy and environmental stressors on NBS metabolites.We examined 49 metabolic biomarkers obtained from routine NBS in 452 infants born preterm for association with maternal environmental stressors and complications of pregnancy.Neonatal free carnitine (C0, p = 1.4 × 10(-7)), acetylcarnitine (C2, p = 2.7 × 10(-7)), octenoylcarnitine (C8:1, p = 5.2 × 10(-11)) and linoleoylcarnitine (C18:2, p = 9.1 × 10(-7)) were elevated in infants born to preeclamptic mothers. Similar elevations were observed in small for gestational age infants and in infants where labor was not initiated prior to delivery. When accounting for all three factors, associations remained strongest between acylcarnitines and preeclampsia.We observed that maternal conditions, particularly preeclampsia, influence NBS biomarkers. This is important for identifying maternal conditions that influence metabolites measured during routine NBS that are also markers of fetal growth and overall health.

SUBMITTER: Ryckman KK

PROVIDER: S-EPMC3753672 | biostudies-literature | 2013 Sep

REPOSITORIES: biostudies-literature

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The influence of maternal disease on metabolites measured as part of newborn screening.

Ryckman Kelli K KK Shchelochkov Oleg A OA Cook Daniel E DE Berberich Stanton L SL Copeland Sara S Dagle John M JM Murray Jeffrey C JC

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 20130502 14

<h4>Objective</h4>Measurements of neonatal metabolites are commonly used in newborn screening (NBS) programs to detect inborn errors of metabolism. Variation in these metabolites, particularly in infants born preterm (<37 weeks gestation), can result from multiple etiologies. We sought to evaluate the impact of maternal complications of pregnancy and environmental stressors on NBS metabolites.<h4>Methods</h4>We examined 49 metabolic biomarkers obtained from routine NBS in 452 infants born preter ...[more]

PMID: 23550828

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Project description:INTRODUCTION:The community score card (CSC) is a participatory monitoring and evaluation tool that has been employed to strengthen the mutual accountability of health system and community actors. In this paper we describe the influence of the CSC on selected maternal and newborn service delivery and utilization indicators. METHODS:This was a mixed methods study that used both quantitative and qualitative data collection methods. It was implemented in five sub-counties and one town council in Kibuku district in Uganda. Data was collected through 17 key informant interviews and 10 focus group discussions as well as CSC scoring and stakeholder meeting reports. The repeated measures ANOVA test was used to test for statistical significance. Qualitative data was analyzed manually using content analysis. The analysis about the change pathways was guided by the Wild and Harris dimensions of change framework. RESULTS:There was an overall improvement in the common indicators across sub-counties in the project area between the 1st and 5th round scores. Almost all the red scores had changed to green or yellow by round five except for availability of drugs and mothers attending Antenatal care (ANC) in the first trimester. There were statistically significant differences in mean scores for men escorting their wives for ante natal care (ANC) (F(4,20)?=?5.45, P?=?0.01), availability of midwives (F(4,16) =5.77, P?<?0.01), availability of delivery beds (F(4,12) =9.00, P?<?0.01) and mothers delivering from traditional birth attendants (TBAs), F(4,16)?=?3.86, p?=?0.02). The qualitative findings suggest that strengthening of citizens' demand, availability of resources through collaborative problem solving, increased awareness about targeted maternal health services and increased top down performance pressure contributed to positive changes as perceived by community members and their leaders. CONCLUSIONS AND RECOMMENDATIONS:The community score cards created opportunities for community leaders and communities to work together to identify innovative ways of dealing with the health service delivery and utilization challenges that they face. Local leaders should encourage the availability of safe spaces for dialogue between communities, health workers and leaders where performance and utilization challenges can be identified and solutions proposed and implemented jointly.

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Dataset Information

The influence of maternal disease on metabolites measured as part of newborn screening.

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The influence of maternal disease on metabolites measured as part of newborn screening.

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