High Baseline Serum Asymmetric Dimethylarginine Level is Related to Delayed Psychomotor Development in Very Low Birth Weight Premature InfantsAuthor(s): Feng-Shun Chen, Kuan-Hung Lin, Mei-Jen Ou-Yang, Hsin-Chun Huang, Pi-Lien Hung, Li-Tong Huang, Chih-Jen Chen, Chun-Yuh Yang, Chih-Cheng Chen
Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of the endothelial nitric oxide synthase, is specifically related with cranial small vessel disease. We aim to investigate the baseline level of serum ADMA in correlation to neurodevelopmental outcomes in a cohort of very low birth weight premature infants.
A total of 50 very low birth weight (VLBW, <1500 g) preterm (gestational age ≦ 30 weeks) infants were included and assigned to a High or Low ADMA baseline level group according to the plasma ADMA levels obtained within 6-12 hours after birth. All patients were followed prospectively for the neurodevelopmental outcomes. Causes of morbidities were analysed and compared.
No differences in gestational age, birth body weight, 1’ and 5’ Apgar scores, gender prevalence, and serum creatinine level were noted between study groups. Premature infants with high ADMA baseline level had a higher incidence of periventricular echogenecity persisting longer than 2 weeks (p= 0.013), and a higher ratio of delayed psychomotor development at 6 and 12 months corrected age (p=0.041 and 0.012). ADMA baseline level is inversely correlated to the Psychomotor Developmental Index at 6 and 12 months corrected age within the high ADMA baseline level group (p=0.02, p=0.027 respectively). The occurrence of retinopathy of prematurity, chronic lung disease, and patent ductus arteriosus requiring medication intervention were of no significant differences between study groups.
Premature infants with high ADMA baseline levels tended to have a higher ratio of delayed psychomotor development at corrected age of 6 and 12 months old. Further studies on perinatal factors related with high ADMA baseline levels are warranted.