Measurement of novel biomarkers of neuronal injury and cerebral oxygenation after routine vaginal delivery versus cesarean section in term infants

Morel, Alexandra Almanzar; Bailey, Sean M.; Shaw, Gerry; Mally, Pradeep; Malhotra, Samir

doi:10.1515/jpm-2014-0274

Cited by 6 publications

(2 citation statements)

References 6 publications

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“…Moreover, NfL levels in infants undergoing therapeutic hypothermia for HIE were significantly higher in those with unfavorable vs. favorable brain magnetic resonance imaging (MRI) outcome ( 11 ). As for mode of delivery, serum NfH levels at day of life (DOL) 2 in a small cohort of newborns did not differ between those born vaginally and those born by cesarean section ( 12 ).…”

Section: Introductionmentioning

confidence: 98%

Neurofilament Light Chain: Blood Biomarker of Neonatal Neuronal Injury

et al. 2018

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Background: Neurofilament light chain (NfL) is a highly promising biomarker of neuroaxonal injury that has mainly been studied in adult neurodegenerative disease. Its involvement in neonatal disease remains largely unknown. Our aim was to establish NfL plasma concentrations in preterm and term infants in the first week of life.Methods: Plasma NfL was measured by single molecule array immunoassay in two neonatal cohorts: cohort 1 contained 203 term and preterm infants, median gestational age (GA) 37.9 weeks (interquartile range [IQR] 31.9–39.4), in whom venous and arterial umbilical cord blood was sampled at birth and venous blood at day of life (DOL) 3; cohort 2 contained 98 preterm infants, median GA 29.3 weeks (IQR 26.9–30.6), in whom venous blood was sampled at DOL 7.Results: Median NfL concentrations in venous blood increased significantly from birth (18.2 pg/mL [IQR 12.8–30.8, cohort 1]) to DOL 3 (50.9 pg/mL [41.3–100, cohort 1]) and DOL 7 (126 pg/mL [78.8–225, cohort 2]) (p < 0.001). In both cohorts NfL correlated inversely with birth weight (BW, Spearman's rho −0.403, p < 0.001, cohort 1; R −0.525, p < 0.001, cohort 2) and GA (R −0.271, p < 0.001, cohort 1; R −0.487, p < 0.001, cohort 2). Additional significant correlations were found for maternal age at delivery, preeclampsia, delivery mode, 5-min Apgar, duration of oxygen supplementation, sepsis, and brain damage (intraventricular hemorrhage or periventricular leukomalacia). Multivariable logistic regression analysis identified the independent predictors of NfL in cohort 1 as BW (beta = −0.297, p = 0.003), delivery mode (beta = 0.237, p = 0.001) and preeclampsia (beta = 0.183, p = 0.022) and in cohort 2 as BW (beta = −0.385, p = 0.001) and brain damage (beta = 0.222, p = 0.015).Conclusion: Neonatal NfL levels correlate inversely with maturity and BW, increase during the first days of life, and relate to brain injury factors such as intraventricular hemorrhage and periventricular leukomalacia, and also to vaginal delivery.

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Section: Introductionmentioning

confidence: 98%

Neurofilament Light Chain: Blood Biomarker of Neonatal Neuronal Injury

et al. 2018

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“…13,14 Current obstetrical practice guidelines emphasize vaginal birth as the preferred delivery method whenever possible, despite the fact that CS rate is increasing in developed and developing countries. 15,16 It is known that term infants born by CS have more health problems in the early neonatal period compared with vaginally born neonates, and that early-term infants have more health problems than later with the effect even on mortality. 17 In our study, neonatal deaths were more frequent in neonates born by CS and in neonates born at 37 weeks of gestation.…”

Section: Discussionmentioning

confidence: 99%

Early Neonatal Morbidity after Term Delivery: How should We respond?

Stanojević¹,

Leko²

2016

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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Aim The aim of this retrospective study was to investigate the influence of gestational age and mode of delivery at term on early neonatal morbidity and mortality in a tertiary maternity center in a 10-year period. Materials and methods The data were derived from the medical records between January 1, 2005, and December 31, 2014, from the University Hospital “Sveti Duh,” Zagreb, Croatia. There were 30,363 live born term infants included in the study. The data from the medical records have been used to analyze their mode of delivery, morbidity, and mortality. Results Term newborn infants delivered by cesarean section (CS) had increased prevalence of lower Apgar scores, resuscitation, neonatal convulsions, and neonatal encephalopathy, respiratory pathology (except for amniotic fluid aspiration), and mechanical ventilation. Early and late neonatal deaths were more prevalent in term infants delivered by CS. The prevalence of birth trauma (except for facial nerve palsy) and hyperbilirubinemia was significantly increased in vaginally born neonates. The prevalence of perinatal infections was equal in both groups of infants. Morbidity and mortality of term newborn infants presented as prevalence per 1,000 live born, regardless of the mode of a delivery week by week from 37 through 41 weeks of gestation, were also investigated. The highest prevalence for most of the observed parameters were at 37 to 41 weeks of gestation, while the lowest prevalence was observed at a gestational age between 39 and 40 weeks. This was not the case for the 1st and the 5th minute 4 to 7 Apgar scores, birth injuries, respiratory pathology, and late neonatal deaths. Conclusion Early-term delivery was connected with more morbidity and mortality in the early neonatal period. It seems that the best gestational age to be born is at 39 to 40 weeks of gestation. Mode of delivery at term counts as well, showing that vaginal delivery at term had the lowest risk of morbidity and mortality. How to cite this article Stanojevic M, Leko L. Early Neonatal Morbidity after Term Delivery: How should We respond? Donald School J Ultrasound Obstet Gynecol 2016;10(2):180-184.

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Neurofilament as a potential biomarker for spinal muscular atrophy

Darras

Crawford

Finkel

et al. 2019

Ann Clin Transl Neurol

166

176

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Objective To evaluate plasma phosphorylated neurofilament heavy chain ( pNF ‐H) as a biomarker in spinal muscular atrophy ( SMA ). Methods Levels of pNF ‐H were measured using the ProteinSimple ® platform in plasma samples from infants with SMA enrolled in ENDEAR ( NCT 02193074) and infants/children without neurological disease. Results Median pNF ‐H plasma level was 167.0 pg/mL (7.46–7,030; n = 34) in children without SMA (aged 7 weeks–18 years) and was higher in those aged < 1 versus 1–18 years ( P = 0.0002). In ENDEAR participants with infantile‐onset SMA , median baseline pNF ‐H level (15,400 pg/mL; 2390–50,100; n = 117) was ~10‐fold higher than that of age‐matched infants without SMA ( P < 0.0001) and ~90‐fold higher than children without SMA ( P < 0.0001). Higher pretreatment pNF ‐H levels in infants with SMA were associated with younger age at symptom onset, diagnosis, and first dose; lower baseline Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders score; and lower peroneal compound muscle potential amplitude. Nusinersen treatment was associated with a rapid and greater decline in pNF ‐H levels: nusinersen‐treated infants experienced a steep 71.9% decline at 2 months to 90.1% decline at 10 months; sham control–treated infants declined steadily by 16.2% at 2 months and 60.3% at 10 months. Interpretation Plasma pNF ‐H levels are elevated in infants with SMA . Levels inversely correlate with age at first dose and several markers of disease severity. Nusinersen treatment is associated with a significant decline in pNF ‐H levels followed by relative stabilization. Together these data suggest plasma pNF ‐H is a promising marker of disease activity/treatment response in infants with SMA.

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Measurement of novel biomarkers of neuronal injury and cerebral oxygenation after routine vaginal delivery versus cesarean section in term infants

Cited by 6 publications

References 6 publications

Neurofilament Light Chain: Blood Biomarker of Neonatal Neuronal Injury

Neurofilament Light Chain: Blood Biomarker of Neonatal Neuronal Injury

Early Neonatal Morbidity after Term Delivery: How should We respond?

Neurofilament as a potential biomarker for spinal muscular atrophy

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