Background and Aims Premature infants are exposed to numerous perinatal stresses such as hypothermia, hypoxia, hypotension, umbilical vessel catheterization. All of these have been postulated as risk factors for ischemic injury of the neonatal intestine. The intestinal permeability is increased in bacterial translocation which can lead to endotoxemia and multiple organ failure. The aim of this study was to determine anti endotoxine immunity (AEI) in premature infant depend on birth weight.

Methods Premature newborns were divided into two groups. The first group consisted of 61newborns with birth weight more than 1500 gram and 20 infant with birth weight less than 1500 gram were included in second study. In this study urinary intestinal fatty acid bind protein (i-FABP) level was measured as a specific marker for intestinal mucosal damage and serum LBP concentration was detected for estimation of AEI. Both markers were determined by enzyme linked immunsorbent assay.

Results The mean i-FABP concentration in the second group (1.75±0.62 ng/ml) was elevated in 1.4 times compared with the first group (1.23±0.23 ng/ml). Significant high urine i-FABP concentration was observed in died infants of second group (2.39±0.88 ng/ml, p<0.05). In contrast the serum LBP level in newborns of second group was lower (23.1±4.5 ng/ml) in 1.4 time compared to newborns of first group (32.1±2.3 ng/ml).

Conclusion Very low birth weight newborns are at increased risk of intestinal mucosal injury and endotoxemia and decreased serum LBP level in these infants should be considered as an unfavorable factor for sepsis.