Profiles of Amino Acid in Indonesian Neonates

Background: Amino acid profiles in newborns is a sign of its nutritional status and it reflects the protein intake of the mother before and during pregnancy. The amino acid level is also a predictor of improved growth velocity and the only tool for diagnosis of amino acid disorder in suspected individuals. In Indonesia, based on National Basic Health Research year 2018, 48.8% of pregnant mother has anemia and 13% babies were underweight. Determining amino acid profiles is important to differentiate pathologic from normal condition in newborn population. There are only a few reports with adequate sample size on amino acid profiles in newborns from South East Asian Countries and none from the Indonesian population.

Methods: This is the first descriptive study in Indonesia newborns population determining the profiles of amino acid concentration from dried blood spot (DBS) sample by liquid chromatography-tandem-mass spectrometry (LC-MS/MS) system. This study used DBS sample obtained from the newborns’ heel pricks, which is easier to store and handle in Indonesia’s landscape. This will allow samples from remote area to be safely transported to referral laboratory.

Results: A total of 993 healthy newborns from 25 provinces and districts in Indonesia were included in this study. All samples were stored at -20oC and analyzed within 1 month. The amino acid concentration profile was summarized as 95% reference interval determined using nonparametric method. The result for most amino acid was only slightly different from previously reported reference from various population which was presumably caused by food preference. This study’s result is expected to be implemented in Indonesian population.

Conclusions: Determining the amino acid profile in neonates using DBS is dependable. The result from this study is expected to be applied in our center and other referral hospital for inborn error of metabolism screening.