Value of biochemical markers for outcome in term infants with asphyxia

Pediatr Neurol. 2004 Nov;31(5):326-32. doi: 10.1016/j.pediatrneurol.2004.05.004.

Abstract

The aim of this study was to define the predictive values of serum and cerebrospinal fluid concentrations of interleukin-6 and neuron-specific enolase and urinary uric acid/creatinine ratio for outcome in term infants with perinatal asphyxia. All biochemical markers were measured simultaneously within the 24-72 hours of life in 21 infants. The infants were monitored with a standardized neurologic and developmental evaluation protocol over the 2 years of life. The overall outcome at 2 years of age was categorized as "favorable" or "adverse". According to Sarnat and Sarnat classification, 12 infants had mild encephalopathy and 9 infants had moderate to severe encephalopathy. Seven of 9 (78%) infants with moderate to severe encephalopathy had adverse outcome. However, all infants with mild encephalopathy had favorable outcome. Interleukin-6 and neuron specific enolase levels in cerebrospinal fluid and serum interleukin-6 levels were significantly correlated with the degree of encephalopathy, as well as the outcome. Interleukin-6 in cerebrospinal fluid (cutoff value, 25.9 pg/mL) had the highest predictive value among the biochemical markers. The predictive factors identified in this study should be examined for their ability in a fresh clinical sample in the neonatal intensive care unit before these markers can be applied to the routine clinical of infants with perinatal asphyxia.

MeSH terms

  • Asphyxia Neonatorum / diagnosis*
  • Asphyxia Neonatorum / metabolism*
  • Asphyxia Neonatorum / therapy
  • Biomarkers
  • Cohort Studies
  • Creatinine / urine*
  • Critical Care
  • Humans
  • Infant, Newborn
  • Interleukin-6 / blood*
  • Interleukin-6 / cerebrospinal fluid
  • Phosphopyruvate Hydratase / blood*
  • Phosphopyruvate Hydratase / cerebrospinal fluid
  • Predictive Value of Tests
  • Severity of Illness Index
  • Treatment Outcome
  • Uric Acid / urine*

Substances

  • Biomarkers
  • Interleukin-6
  • Uric Acid
  • Creatinine
  • Phosphopyruvate Hydratase