Association between newborn screening analytes and hypoxic ischemic encephalopathy

Abstract

Hypoxic ischemic encephalopathy (HIE) is a major cause of neonatal mortality and morbidity. Our study sought to examine whether patterns of newborn screening analytes differed between infants with and without neonatal HIE in order to identify opportunities for potential use of these analytes for diagnosis in routine clinical practice. We linked a population-based newborn screening registry with health databases to identify cases of HIE among term infants (≥37 weeks’ gestation) in Ontario from 2010–2015. Correlations between HIE and screening analytes were examined using multivariable logistic regression models containing clinical factors and individual screening analytes (acyl-carnitines, amino acids, fetal-to-adult hemoglobin ratio, endocrine markers, and enzymes). Among 731,841 term infants, 3,010 were diagnosed with HIE during the neonatal period. Multivariable models indicated that clinical variables alone or in combination with hemoglobin values were not associated with HIE diagnosis. Although the model was improved after adding acyl-carnitines and amino acids, the ability of the model to identify infants with HIE was moderate. Our findings indicate that analytes associated with catabolic stress were altered in infants with HIE; however, future research is required to determine whether amino acid and acyl-carnitine profiles could hold clinical utility in the early diagnosis or clinical management of HIE. In particular, further research should examine whether cord blood analyses can be used to identify HIE within a clinically useful timeframe or to guide treatment and predict long-term health outcomes.

Application Effect Analysis of Clinical Nursing Pathway in the Care of Neonatal Hypoxic-Ischemic Encephalopathy

“…HIE is a brain dysfunction related to oxygenation and blood flow insufficiency [ 17 ]. Our research has confirmed that CNP has a good application effect in the care of NHIE, which can significantly promote the PMD, intelligence development, ND, and physique growth of HIE children with a favorable safety profile.…”

Pleiotrophin ameliorates white matter injury of neonatal rats by activating the mTOR/YY1/Id4 signaling pathway

“…42 Moreover, clinical studies have shown that the severity of brain injuries in male newborns is higher than that in female newborns, and the recovery ability of males is lower than that of females. 43,44 Kuboyama et al 45 found that in a primary mixed mouse glial cell culture, PTN treatment enhanced the differentiation of OL lineage cells into MBP-positive mature OLs. Goebbels et al 18 showed that in primary OL cultures, adding recombinant human protein PTN could effectively stimulate myelination.…”

“…Furthermore, in our study, we only selected male rats because other studies indicated that male neonatal rats had more severe brain damage than female rats under the same conditions 42 . Moreover, clinical studies have shown that the severity of brain injuries in male newborns is higher than that in female newborns, and the recovery ability of males is lower than that of females 43,44 …”

Metabolic gestational age assessment in low resource settings: a validation protocol

“…NSO is equipped with sufficient personnel and laboratory resources to accommodate the inclusion of international clinical and research samples into the organization's standard workflow. The organization is currently providing newborn screening services to remote communities in other Canadian provinces/territories, and has piloted international screening services 14 .…”