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Subject Area

Pediatrics

Article Type

Original Study

Abstract

Objective To assess the diagnostic and prognostic values of ischemia-modified albumin (IMA) in neonates with transient tachypnea of the newborn (TTN). Background TTN results from failure of the newborn to effectively clear fetal lung fluids after birth. TTN represents a common etiology of respiratory distress in term newborns. IMA is a modification of serum albumin and results from oxidative stress that occurs during ischemic events regardless of its tissue specificity. Patients and method This prospective case–control study was conducted on 88 full-term newborns, who were admitted to the neonatal ICU of Menoufia University Hospital. They were divided into two groups, group I 'cases' (n = 44) included newborns more than or equal to 37 weeks gestational age diagnosed as TTN and were managed with nasal O2 (group Ia, n = 28) or with continuous positive airway pressure (group Ib, n = 16) and group II 'control' (n = 44) healthy, full-term newborns, age-matched and sex-matched with group I, with no respiratory distress. All newborns were subjected to full history, clinical examinations, and laboratory investigations. Blood sample was collected during the first 24 h. Results Levels of IMA were found to be significantly higher in group I than in group II at a cutoff point more than or equal to 188 ng/ml for the diagnosis of TTN (sensitivity 95.4%, and specificity 97.7%) (area under the curve = 0.997, P < 0.05). Also, levels of IMA were found to be significantly higher in group Ib when compared with group Ia at a cutoff point more than or equal to 295 ng/ml for the assessment of disease severity (sensitivity 92.8% and specificity 87.5%) (area under the curve = 0.972, P < 0.05). Conclusion IMA was a sensitive marker for the diagnosis of TTN at cutoff point more than or equal to 188 ng/ml and was able to predict disease severity at cutoff point more than or equal to 295 ng/ml.

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