Clinical and laboratory observations
Urinary β2-microglobulin in premature infants with chorioamnionitis and chronic lung disease

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Abstract

The urinary β2-microglobulin (MG) concentration on day 0 to 2 was significantly higher in premature infants with chorioamnionitis (CAM) than in infants without CAM and in infants who developed chronic lung disease (CLD) than in those who did not. We propose that an elevated urinary β2-MG can indicate a fetal inflammatory response and identify neonates at risk for the development of CLD.

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Patients

Infants admitted to the Yokohama City University Hospital neonatal intensive care unit between March 2000 and February 2002 were eligible for study entry if they met the following criteria: (1) gestational age at birth ≤32 weeks, (2) spontaneously voided urine samples obtained using urine bags before 48 hours of age, (3) diagnosis of CLD after 28 days of survival, and (4) absence of major intraventricular hemorrhage (grades III and IV), congenital anomalies, and early-onset sepsis on admission.

Patients

There were no significant differences in birth weight and gestational age between the non-CAM and CAM group (1226 vs 1060 g, P = .8654 and 28.0 vs 28.0 weeks, P = .5251); however, the infants with CLD were smaller (892 vs 1234 g, P<.0001) and less mature (26.0 vs 29.0 weeks, P<.0001) than those without CLD. CLD developed in 14 infants (36.8%) in the CAM group and 4 (12.9%) in the non-CAM group, whereas CAM was diagnosed in 14 (77.8%) in the CLD group and 24 (47.1%) in the non-CLD group. Maternal

Discussion

We found several meaningful relationships between the neonatal urinary β2-MG levels measured on day 0 to 2 and the maternal CAM or neonatal CLD development. The urinary β2-MG levels were significantly higher in premature infants born to mothers with CAM than in infants without CAM. However, urinary β2-MG values were not elevated in approximately one third of the infants in the CAM group. One explanation would be that urinary β2-MG values rise if there is an accompanying fetal inflammatory

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