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Am J Perinatol. 2017 Feb;34(3):240-247. doi: 10.1055/s-0036-1585419. Epub 2016 Jul 25.

Early Elevation in Interleukin-6 is Associated with Reduced Growth in Extremely Low Birth Weight Infants.

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Department of Pediatrics, Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, Ohio.
Statistics and Epidemiology Unit, RTI International, Research Triangle Park, North Carolina.
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
Department of Clinical Biochemistry and Immunology, Section of Neonatal Screening and Hormones, Statens Serum Institut, Copenhagen, Denmark.
Department of Pediatrics, Neonatal-Perinatal Medicine, Wayne State University, Detroit, Michigan.
Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
Division of Perinatal Medicine, Department of Pediatrics, Yale-New Haven Children's Hospital and the Yale University School of Medicine, New Haven, Connecticut.


Objective To determine whether reduced growth velocity (GV) in extremely low birth weight infants is preceded by elevated inflammatory cytokines. Study Design GV was determined at 36 weeks' postmenstrual age (PMA) in 768 infants 401 to 1,000 g birth weight (BW). Association between blood cytokines measured through day of life 21 and GV was explored using linear regression models that adjusted for late-onset sepsis (LOS), BW, small for gestational age (SGA), gender, race, energy intake, and center. Results Serum interleukin-6 (IL-6) was increased at days 14 and 21 in LOS infants. LOS was associated with reduced energy intake and GV for weight (weight-GV) at 36 weeks' PMA. Linear regression analysis controlling for LOS and energy intake showed significant relationships between increased IL-6 at days 14 and 21 with reduced weight-GV at 36 weeks' PMA (p < 0.0001). The relationship between day 21 IL-6 and weight-GV was not associated with LOS (p = 0.12) when controlling for BW and energy intake. Both BW (p = 0.02) and energy intake (p = 0.003) influenced the relationship between day 14 IL-6 and weight-GV. Conclusion IL-6 elevation during the first month of life is associated with lower weight-GV at 36 weeks' PMA and may have a direct effect upon energy balance and postnatal growth.

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