Effects of Gestational Age and Perinatal-Asphyxia in the Concentration of Carnitine in Umbilical Blood

Abstract

Carnitine is an amino acid (3-hydroxy-4N-trimethyl­ aminobutyric acid) that plays an essential role in transfer of long chain fatty acids across the inner mitochondrial membrane for their subsequent P-oxidation and energy production. Furthermore carnitine also helps in detoxification of acyl moieties, and in maintaining normal levels of free coenzyme A The body's supply of carnitine is derived in part, from food and, in part, by endogenous synthesis from lysine and methionine in liver, kidneys and muscles. In the immediate post notal period, fat is the mam source of energy, optimum oxidation of fatty acids requires carnitine. Some evidence suggests that the ability of neonates to synthesize carnitine is limited by immature hepatic y­ butyrobetaine hydroxylase activity, possibly making neonates, particularly preterms, dependent on exogenous intake of carnitine for maintenance of normal plasma level. A plethora of factors influences the concentration of carnitine in umbilical plasma, among which is the maternal lipid profile, the perinatal conditions (e.g. perinatal asphyxia, premature rupture of membranes .....), the mode of delivery and the gestational age.