Document Type : Original Article
Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Department of Clinical Pathology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Department of Pediatrics, Faculty of Medicine, Universitas Padjajaran, Bandung, Indonesia
Background: Premature birth is linked to neonatal morbidity and mortality worldwide. Neuregulin (NRG) is a trophic factor from the growth factor (GF) of a transmembrane polypeptide, encoded by four different genes, including NRG-1 which acts as an endogenous protector in fetal development. Decreased levels of NRG-1 affect several organs. The relationship between NRG-1 polymorphism and the outcome of neonatal development has been widely studied. There are no studies that have assessed NRG-1 levels and NRG-1 rs35753505 C/T polymorphism in preterm neonates, as well as its association with short-term morbidities in Indonesia.
Methods: This cross-sectional study was conducted on preterm neonates with the gestational age of 32-36 weeks in Medan, North Sumatera, Indonesia, from December 2017 to December 2018. It aimed to evaluate the association of NRG-1 levels and NRG1 polymorphism with short-term morbidities. Samples were obtained from cord blood specimens. Enzyme-linked immunosorbent assay (ELISA) was used to determine NRG-1 levels, and NRG-1 polymorphism was sequenced by polymerase chain reaction (PCR). Observations in preterm neonates were made during the first 72 h to assess short-term morbidities.
Results: During the study period, 48 cord blood specimens from preterm neonates were found eligible for analysis. Preterm neonates with low NRG-1 levels had a 10-times higher risk of developing short-term morbidities. The presence of CC and CT genotypes increased the risk of developing short-term morbidities 13.33 times (P=0.003) and 6.19 times (P=0.019), respectively. The presence of the C allele in subjects' genotype increased the risk of short-term morbidities 4.04 times (P=0.001), compared to those with T allele.
Conclusion: As evidenced by the obtained results, preterm neonates with low NRG-1 levels had a higher risk of developing short-term morbidities. Furthermore, there was a significant association between NRG-1 rs35753505 C/T polymorphism and short-term morbidities.