283 - Plasma Serotonergic Biomarkers are Associated with Hypoxemia Events in Preterm Neonates

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 283
Publication Number: 283.428

Peter M. MacFarlane, Case Wester Reserve University/Rainbow Babies & Children's Hospital, Cleveland, OH, United States; Richard J. Martin, Rainbow Babies, Lyndhurst, OH, United States; Juliann Di Fiore, Case Western Reserve University, Cleveland, OH, United States; Thomas M. Raffay, UH Rainbow Babies and Children's Hospital, Cleveland, OH, United States; Curtis Tatsuoka, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Zhengyi Chen, Case Western Reserve University School of Medicine, Cleveland, OH, United States; Nori M. Minich, Case Western Reserve University School of Medicine, Cleveland, OH, United States; Guillermo Quintas, LEITAT TECHNOLOGICAL CENTER, VALENCIA, Comunidad Valenciana, Spain; Ángel Sánchez-Illana, University of Valencia, Burjassot, Comunidad Valenciana, Spain; Julia Kuligowski, Health Research Institute La Fe, Valencia, Comunidad Valenciana, Spain; José David Piñeiro-Ramos, Health Research Institute La Fe, Valencia, Comunidad Valenciana, Spain; Maximo Vento, Health Research Institute La Fe, VALENCIA, Comunidad Valenciana, Spain; Anna Maria Hibbs, UH Rainbow Babies & Children's Hospital, Cleveland, OH, United States

Presenting Author(s)

Peter M. MacFarlane, PhD (he/him/his)

Associate Professor
Case Wester Reserve University/Rainbow Babies & Children's Hospital
Cleveland, Ohio, United States

Background: Hypoxemia is a physiological manifestation of immature respiratory control and lung disease in preterm neonates, which is likely impacted by neurotransmitter imbalances. Serotonin (5-HT) and kynurenic acid (KA), products of tryptophan metabolism, are neuromodulators and have been implicated in modulation of respiratory control in neonatal animals.

Objective: To examine associations of the 5-HT and KA in plasma with intermittent hypoxia (IH) events and percent time < 80% in preterm infants.

Design/Methods: The cohort study was the Prematurity-Related Ventilatory Control (Pre-Vent) study at the Case Western Reserve University site. 5-HT and KA were analyzed in p</span>latelet poor plasma by liquid chromatography coupled to tandem mass spectrometry at ~1 week and ~1 month of life from a prospective cohort of 175 preterm neonates < 31 weeks gestational age (GA). Frequency of IH events and percent time hypoxemic < 80% were analyzed in a 6h window after the blood draw by GEE ordinal logistic regression models.

Results: At 1 week, infants with detectable plasma 5-HT had fewer IH events (OR (95% CI) = 0.52 (0.29, 0.92)) and less percent time < 80% (OR (95% CI) = 0.54 (0.31, 0.95)) compared to infants with undetectable 5-HT (Fig. 1). A similar relationship occurred at 1 month. At 1 week, infants with higher KA showed greater percent time < 80% (OR (95% CI) = 1.90 (1.03, 3.50)). KA was not associated with IH frequency at either postnatal age. IH frequency and percent time < 80% were positively associated with GA< 29 weeks.

Conclusion(s):

Circulating neuromodulators 5-HT and KA, representing biomarkers of immature respiratory control, may contribute to hypoxemia in preterm neonates.