Inter-Alpha Inhibitor Proteins as a Predictor of Necrotizing Enterocolitis in Newborn Infants

Abstract

Necrotizing enterocolitis is a devastating emergency, multifactorial disease. Inter-alpha inhibitor proteins are serine protease inhibitors involved in many physiological and pathological activities.Aim: this study was designed in order to assess the value of inter-alpha inhibitor proteins in predicting and improving accuracy of diagnosis of NEC in newborn infants with non-precise abdominal and intestinal manifestations.Materials and Methods. This study was prospective longitudinal research that included 80 newborn infants presented with non-specific abdominal manifestations. Infants were divided into two groups. Group A; infants who developed necrotizing enterocolitis, they had stage II or III necrotizing enterocolitis according to modified Bell's criteria. Group B; included infants who did not develop necrotizing enterocolitis. Serum inter alpha inhibitor proteins level was measured by ELISA.Results. In necrotizing enterocolitis group, the median inter-alpha inhibitor protein level was (9.38 mg/L), this was significantly lower than non-necrotizing enterocolitis group (44.40 mg/L), P<0.01. Inter-alpha inhibitor protein was reduced in stage IA than stage IIIB. Inter-alpha inhibitor protein values were decreased in preterm and full term infants with sensitivity of 98 % and specificity of 96% at cutoff <19.42 and <19.96 mg/L. The cut off in non-survival cases was >13.29 mg/L with sensitivity of 53.33 % and specificity of 92.31%.Conclusion. Inter-alpha inhibitor protein levels were reduced in full term and preterm infants with necrotizing enterocolitis, consequently it may improve diagnosis of necrotizing enterocolitis in newborn infants. It has prognostic value and correlate with severity of necrotizing enterocolitis. It might predict non-survival cases.

Keywords

• necrotizing enterocolitis
• newborn infants
• inter-alpha inhibitor proteins
• surgical neonatal emergencies
• newborn infants
• preterm infants