Original ArticleBiomarkers for Severity of Neonatal Hypoxic-Ischemic Encephalopathy and Outcomes in Newborns Receiving Hypothermia Therapy
Section snippets
Methods
This prospective cohort pilot study included all inborn infants ≥36 weeks of gestation and birth weight ≥1800 g who were admitted to the neonatal intensive care unit at Parkland Memorial Hospital, Dallas, TX, from June 2010 to June 2011 and had perinatal asphyxia with metabolic acidosis. Exclusion criteria included the presence of congenital anomalies or if comfort care was planned. The study was approved by the Institutional Review Board of the University of Texas Southwestern Medical Center.
Results
Of 14 000 inborn neonates, 100 (0.7%) had perinatal acidosis and were admitted to the neonatal intensive case unit for neurologic assessment of encephalopathy. Twenty-two infants, 1.6 per 1000 live births, had moderate to severe encephalopathy and were treated with hypothermia. One patient with severe HIE was excluded because he died within hours of birth, and there was no parental consent for another newborn. The hypothermia study group was composed of 20 newborns (17 with moderate and 3 with
Discussion
This pilot cohort study examined an array of neuronal specific serum biomarkers and circulating inflammatory cytokines known to be involved in the excitatory-oxidative cascade of brain injury in infants with HIE. Key findings were: (1) a concentration-dependent relationship between serum GFAP at birth and the severity of encephalopathy; (2) the absence of a surge in any serum biomarkers after rewarming; and (3) evidence that a panel of inflammatory and neuronal biomarkers measured at 6-24 hours
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L.C. is supported by the National Institutes of Health (K23HD069521) and the Gerber Foundation. The authors declare no conflicts of interest.