Relationship Between Maternal And/or Newborn Cholesterol Levels and Neonatal Septicemia: Protocol for a Ugandan Cohort of Mother-newborn Pairs

Overview

Journal BMC Pediatr

Publisher Biomed Central

Specialty Pediatrics

Date 2022 Jul 20

PMID 35858938

Authors

Kenneth Ssebambulidde

Anthony Kayiira

Ivan Segawa

Sylvia Namanda

Victoria Nakibuuka

Victor Musiime

Theresa H Ward

Affiliations

Soon will be listed here.

Abstract

Background: Many aspects of microbial dissemination appear to vary with host cholesterol levels. Since neonatal septicemia remains a leading cause of newborn admissions and mortality in resource-limited settings, the contribution of abnormal cholesterol levels in maternal and/or newborn blood to the risk of neonatal septicemia and outcome requires elucidation. We aim to determine a relationship between maternal serum and neonatal cord blood cholesterol levels and neonatal septicemia.

Methods: This will be a mother-newborn pair cohort study. Approximately 353 pregnant women who are eligible and consent to participate in the study will have blood drawn for a lipid profile. Upon delivery, we will analyse the cord blood cholesterol of their newborns and follow them for 28 days to determine whether the infants develop clinical signs and symptoms suggestive of neonatal septicemia. Relative risk will be used to determine the association between cholesterol and newborn septicemia. Poisson regression will be used to estimate the relative risk (with 95% confidence intervals) of developing septicemia.

Discussion: Findings from our study will contribute evidence to support the inclusion of lipid profile screening for pregnant women and newborns. Our study will determine whether newborns with abnormal cholesterol or those born to mothers with abnormal cholesterol will require rigorous follow-up in neonatal clinics.

Citing Articles

A meta-analysis of the association between inflammatory cytokine polymorphism and neonatal sepsis.

Liang J, Su Y, Wang N, Wang X, Hao L, Ren C PLoS One. 2024; 19(6):e0301859.

PMID: 38848433 PMC: 11161124. DOI: 10.1371/journal.pone.0301859.

References

John B, David M, Mathias L, Elizabeth N . Risk factors and practices contributing to newborn sepsis in a rural district of Eastern Uganda, August 2013: a cross sectional study. BMC Res Notes. 2015; 8:339. PMC: 4529696. DOI: 10.1186/s13104-015-1308-4. View

Bever A, Mumford S, Schisterman E, Sjaarda L, Perkins N, Gerlanc N . Maternal preconception lipid profile and gestational lipid changes in relation to birthweight outcomes. Sci Rep. 2020; 10(1):1374. PMC: 6987205. DOI: 10.1038/s41598-019-57373-z. View

Bryan A, Farnoud A, Mor V, Del Poeta M . Macrophage cholesterol depletion and its effect on the phagocytosis of Cryptococcus neoformans. J Vis Exp. 2014; (94). PMC: 4396961. DOI: 10.3791/52432. View

Alam M, Saleem A, Shaikh A, Munir O, Qadir M . Neonatal sepsis following prolonged rupture of membranes in a tertiary care hospital in Karachi, Pakistan. J Infect Dev Ctries. 2014; 8(1):67-73. DOI: 10.3855/jidc.3136. View

Loh L, McCarthy E, Narang P, Khan N, Ward T . Escherichia coli K1 utilizes host macropinocytic pathways for invasion of brain microvascular endothelial cells. Traffic. 2017; 18(11):733-746. DOI: 10.1111/tra.12508. View

Achan J, Wanzira H, Mpimbaza A, Tumwine D, Namasopo S, Nambuya H . Improving the quality of neonatal data capture and clinical care at a tertiary-care hospital in Uganda through enhanced surveillance, training and mentorship. Paediatr Int Child Health. 2019; 40(2):92-104. DOI: 10.1080/20469047.2019.1638131. View

JOHNSON Jr H, Simpson E, Carr B, MACDONALD P, PARKER Jr R . The levels of plasma cholesterol in the human fetus throughout gestation. Pediatr Res. 1982; 16(8):682-3. DOI: 10.1203/00006450-198208000-00021. View

Kayom V, Mugalu J, Kakuru A, Kiguli S, Karamagi C . Burden and factors associated with clinical neonatal sepsis in urban Uganda: a community cohort study. BMC Pediatr. 2018; 18(1):355. PMC: 6234629. DOI: 10.1186/s12887-018-1323-4. View

Woollett L . Where does fetal and embryonic cholesterol originate and what does it do?. Annu Rev Nutr. 2008; 28:97-114. DOI: 10.1146/annurev.nutr.26.061505.111311. View

10.

Rafi M, Miah M, Wadood M, Hossain M . Risk factors and etiology of neonatal sepsis after hospital delivery: A case-control study in a tertiary care hospital of Rajshahi, Bangladesh. PLoS One. 2020; 15(11):e0242275. PMC: 7665583. DOI: 10.1371/journal.pone.0242275. View

11.

Guirgis F, Donnelly J, Dodani S, Howard G, Safford M, Levitan E . Cholesterol levels and long-term rates of community-acquired sepsis. Crit Care. 2016; 20(1):408. PMC: 5180408. DOI: 10.1186/s13054-016-1579-8. View

12.

Ranjeva S, Warf B, Schiff S . Economic burden of neonatal sepsis in sub-Saharan Africa. BMJ Glob Health. 2018; 3(1):e000347. PMC: 5859806. DOI: 10.1136/bmjgh-2017-000347. View

13.

Iribarren C, Jacobs Jr D, Sidney S, Claxton A, Feingold K . Cohort study of serum total cholesterol and in-hospital incidence of infectious diseases. Epidemiol Infect. 1998; 121(2):335-47. PMC: 2809530. DOI: 10.1017/s0950268898001435. View

14.

Okala S, Sise E, Sosseh F, Prentice A, Woollett L, Moore S . Maternal plasma lipid levels across pregnancy and the risks of small-for-gestational age and low birth weight: a cohort study from rural Gambia. BMC Pregnancy Childbirth. 2020; 20(1):153. PMC: 7068879. DOI: 10.1186/s12884-020-2834-1. View

15.

Shoji H, Murano Y, Mori M, Matsunaga N, Ohkawa N, Suganuma H . Lipid profile and atherogenic indices soon after birth in Japanese preterm infants. Acta Paediatr. 2013; 103(1):22-6. DOI: 10.1111/apa.12436. View

16.

Kaysen G, Ye X, Raimann J, Wang Y, Topping A, Usvyat L . Lipid levels are inversely associated with infectious and all-cause mortality: international MONDO study results. J Lipid Res. 2018; 59(8):1519-1528. PMC: 6071781. DOI: 10.1194/jlr.P084277. View

17.

Waage C, Mdala I, Stigum H, Jenum A, Birkeland K, Shakeel N . Lipid and lipoprotein concentrations during pregnancy and associations with ethnicity. BMC Pregnancy Childbirth. 2022; 22(1):246. PMC: 8953044. DOI: 10.1186/s12884-022-04524-2. View

18.

Chen Q, Chen H, Xi F, Sagnelli M, Zhao B, Chen Y . Association between maternal blood lipids levels during pregnancy and risk of small-for-gestational-age infants. Sci Rep. 2020; 10(1):19865. PMC: 7669834. DOI: 10.1038/s41598-020-76845-1. View

19.

Kannan S, Audet A, Huang H, Chen L, Wu M . Cholesterol-rich membrane rafts and Lyn are involved in phagocytosis during Pseudomonas aeruginosa infection. J Immunol. 2008; 180(4):2396-408. DOI: 10.4049/jimmunol.180.4.2396. View

20.

van Stiphout W, Hofman A, de Bruijn A . Serum lipids in young women before, during, and after pregnancy. Am J Epidemiol. 1987; 126(5):922-8. DOI: 10.1093/oxfordjournals.aje.a114729. View