Plasma carnitine levels in preterm infants with respiratory distress syndrome

RDS is one of the commonest causes of morbidity in preterm infants. It is caused by deficiency of surfactant, a lipoprotein responsible in lowering the surface tension in the alveoli, which results in decrease lung compliance, and alveolar hypoventilation. Enhanced transplacental transfer of Carnitine in earlier stages of pregnancy is thought to result in higher plasma Carnitine levels in preterm infants. In contrast, tissue carnitine levels are directly proportional to the advancing gestational age and thus, preterm infants have lower tissue Carnitine reserves Pulmonary surfactant production is an important process in fetal lung maturation. As Carnitine is an integral component of the membrane phospholipid fatty acid turnover in human cells, it is possible that Carnitine causes lung maturation via membrane phospholipid repair activity Our aim was to investigate the status of free Carnitine level in maternal and neonatal plasma of preterm infants with respiratory distress syndrome (R.D.S) in the first hours of life 50 Preterm infants of ≤ 35 weeks of gestational age and their mothers were enrolled in the study. Preterm infants who developed R.D.S in the first 6 h of life were enrolled in the study group while the infants who did not develop R.D.S served as the control group Mothers with chronic hypertension, premature prolonged rupture of membranes, chorioamnionitis, multiple gestations and infants with perinatal hypoxia, intrauterine growth retardation, congenital malformations and inherited metabolic diseases were excluded from the study Plasma free Carnitine levels are measured. Maternal venous blood samples are drawn 6 h before delivery and neonatal peripheral or umbilical arterial blood samples are drawn in the first 2 h of life plasma free Carnitine of Preterm infants who did not develop R.D.S was (15.33±1.79 mg/L) and their Maternal plasma free Carnitine was (43.44±4.35 mg/L). While in infants who developed R.D.S in the first 6 h of life. was (12.41±1.94 mg/L) and their Maternal plasma free Carnitine was (36.4±4.8 mg/L).We found that there was a highly positive correlation between baby and maternal Carnitine. There was highly positive correlation between Carnitine plasma concentration and gestational age as well as body weight of the new born. The sex of the newborn has no effect on the level of L-Carnitine. Also we found that, there were non-significant differences between neonates with and without antenatal steroids as regard to neonatal plasma free Carnitine and maternal plasma free Carnitine.