الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
The aim of the work was to measure serum copper levels in preterm neonates and to correlate these levels with the anthropometric measurments at birth and the laboratory findings.
This cross-sectional study was conducted at Neonatal Intensive Care Unit at Zagazig University Hospitals in the period from January 2014 to January 2015.
This study included 92 Egyptian neonates with admission to NICU enrolled by random sampling. Informed concent was taken from parents of each case. The study was approved by the university medical ethical committee. The study included all preterm babies ( less than 37 ) who were admitted at Neonatal Intensive Care Unit .It excluded full term babies ( more than 37 weeks), and babies with congenital anomalies that can affect anthropometric measurements at birth as hydrocephalus, sacral agenesis or myopathies were excluded from this study.
All included neonates were subjected to full history taking, complete examination of the neonates and measurement of hemoglobin, calcium, phosphorus, alkaline phosphatase, serum albumin, total protein and serum copper level before their discharge.
The present study results showed a mean gestational age of preterm neonates of 31.38 weeks, a mean body weight of 1538.5 gm, a mean length of 41.97cm, a mean head circumference of 28.33 cm and a mean maternal age of 26.18 years. More than half of study babies were delivered by CS (57.6%) and 63% of them had one or more risk factor for preterm labor.
Laboratory investigations in the present study were a mean hemoglobin of 10.65 ± 1.44 g/dl, a mean calcium of 8.85 ± 0.99 mg/dl, a mean phosphorus of 3.20 ± 0.69 mg/dl, a mean serum alkaline phosphatase of 424.17 ± 80.38 iu/l, a mean albumin of 2.63 ± 0.64 g/dl and a mean total protein of 4.17 ± 0.65 g/dl.
In the present study, the mean of serum copper level was 35.49 µg/dl. Regarding Cu deficiency, when considering the normal Cu level (26-32) µg/dl, there were 20 cases (21.7%) among the study preterms.
The present study showed that there was no difference between cases with deficient Cu level and cases without in sex distribution. There were differences between them in mode of delivery, with increased CS among deficient cases, in maternal risk factors for preterm labor, almost all deficient cases had 1 or more risk factors and in gestational age, deficient cases were more preterm.
The present study showed that there were strong direct correlations a well correlation between copper level with gestational age, the anthropometric measurements and the laboratory findings of the study group, except for serum alkaline phosphatase that had an inverse correlation with copper.
The present study showed that there were strong direct correlation between gestational age with the anthropometric measurements and the laboratory findings except for serum alkaline phosophatase that had an inverse correlation with it.
In the present study, after applying a multivariate analysis of significant variables that correlated with Cu level in the studied group, the gestational age, Ca level and alkaline phosphatase level were still in significant correlations with Cu while the other factors became non significant. This is in agreement with the finding that preterm MBD arises from dietary mineral deficiency with copper deficiency implication, as a result of abnormal collagen metabolism & it is difficult to differentiate these two processes, because they often occur in the same patient (Greer and Tsang ,2006).
In the present study, after applying multivariate analysis of significantly correlated variables with gestational age, only body weight, Hb level and Cu level still had strong significant correlations with gestational age while the other factors became non significant.