271 - Presence of benzyl alcohol in urine of premature neonates in first three days of life
Friday, April 28, 2023
5:15 PM – 7:15 PM ET
Poster Number: 271 Publication Number: 271.131
Daniela Ostrov, University of Illinois College of Medicine, Northbrook, IL, United States; JENNIFER T. PHAM, University of Illinois - - Chicago, IL, Chicago, IL, United States; De-Ann Pillers, University of Illinois College of Medicine, Chicago, IL, United States
Undergraduate Student University of Illinois College of Medicine Northbrook, Illinois, United States
Background: Benzyl alcohol is an antimicrobial preservative that is widely used in medications and fluids. Studies conducted in the 1980s concluded that benzyl alcohol can be associated with adverse effects in premature neonates such as “gasping syndrome”, kernicterus, intraventricular hemorrhage, among others. On May 28, 1982, the Food and Drug Administration (FDA) issued a letter to physicians and hospitals nationwide stating the apparent toxicity of benzyl alcohol in premature infants and recommending that products with benzyl alcohol be excluded from use in premature neonates. Objective: The objective of this study was to determine whether there is a presence of benzyl alcohol and its metabolites in the urine of neonates. We hypothesized that there would not be any presence of benzyl alcohol in neonatal urine because infants in their first three days of life should not have significant exposure to benzyl alcohol due to its toxicity. Design/Methods: Urine samples from 400 premature infants were collected on each day for the first three days of life. Metabolomics was performed by Metabolon Inc. (North Carolina). Ultrahigh performance liquid chromatography-tandem mass spectroscopy was used to determine which biochemicals were present in the samples. Results: Six-hundred eight-four sampleswere analyzed. Mean gestational age was 32.2 (range 23 - 36 weeks) and mean birthweight was 1739 (range 470 - 3651 grams). About 51% of neonates were female. There was a presence of benzoic acid, a metabolite of benzyl alcohol, in all of the neonatal urine samples. There was an inverse correlation between gestational age and birthweight of neonates and amount of benzoic acid present. Infants who are more premature and smaller had higher benzoic acid levels compared to mature and larger infants.
Conclusion(s): This study indicates that metabolites of benzyl alcohol are present in premature neonatal urine. It remains necessary to identify how the substances entered the neonates.
