SERIAL COPPER AND CERULOPLASMIN LEVELS IN AFRICAN NEWBORNS WITH EMPHASIS ON THE SICK AND STABLE PRETERM INFANT, AND THEIR ANTIOXIDANT CAPACITIES

Literature on serum copper (Cu) and its antioxidant protein (cerulopla smin) ill the African newborn is infrequent, and more reports are evid ent from developed or affluent societies. We, therefore, studied longi tudinally our newborns to delineate their Cu and ceruloplasmin (CLP) s tatus. All infants were born between July 1st, 1991 and June 30th, 199 2 at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria . The preterm infants (PI) (gestational age 36 weeks) were divided int o 2 cohorts; A, sick and B, stable; commencing with n = 30 in each gro up. The groups were matched in respect to gender, gestational age, bir thweight, Apgar scores and socioeconomic class. Cu levels were contemp oraneously also determined in 30 (M:F, 17:13) stable full-term infants (appropriate-for-dates). Cu determination was made with atomic absorp tion spectrophotometry and CLP according to colorimetric P-phenylenedi amine assay. Sick PI (cohort A) had significantly lower mean (SD) Cu a nd CLP levels at birth; 0.1 (0.2) mu mol/ml and 0.5 (0.8) mu mol/dl vs 0.6 (0.2) mu mol/ml and 12.5 (1.2) mu mol/dl in stable PI (cohort B), respectively; P < 0.05. Cu level was significantly increased by 4 wee ks in cohort A; P < 0.001 (n = 25) and approached levels of the stable PI (0.7 (0.3) vs 0.8 (0.2) mu mol/ml). Concerning CLP, however, catch -up of levels was delayed till 8 weeks, and a triphasic pattern of lin ear rise in Cu (both cohorts, but more prominent in A) and CLP (cohort A) was discernible by 24 weeks. The sick PI had mean (SD) serum CLP l evels of 0.5 (0.8) mu mol/dl, 5.9 (1.4), 15.2 (2.6), 17.3 (2.9), 21.2 (3.8), 25.1 (4.7) and 23.7 (3.8) mu mol/dl at birth, 4, 8, 12, 20, and 24 weeks, respectively and were similar from 8 weeks in cohort B. Gen erally, CLP paralleled serum Cu levels. Cu levels in the full-term inf ant (FI) were higher at birth and became similar to PI's from 12 weeks , but were overtaken by levels in PI (both cohorts) at 24 weeks. The F I's Cu was significantly elevated by 8 weeks; mean (SD), 0.81 (0.16) m u mol/ml vs 1.25 (0.19) mu mol/ml; P < 0.01, paired t-test. Decreased growth rate, nonpitting pedal edema, exaggerated physiological anaemia and chronic lung disease were few morbidities noted in association wi th very low Cu and CLP levels (n = 15). Newborns with serum Cu and CLP >0.2 mu mol/ml and >2.3 mu mol/dl, respectively, did not have a poor o utcome. It is tempting to suggest that absent serum CLP activity may p ortend a poor prognosis. Our findings (number albeit small) could be t aken as a preliminary normative data for further comparisons. (C) 1998 Elsevier Science Inland Ltd. All rights reserved.