title: Non protein bound iron as early predictive marker of neonatal brain damage.
abstract: Of the approximately 130 million births worldwide each year, four million infants will suffer from birth asphyxia and, of these, one million will die and a similar number will develop serious sequelae. Before being able to develop effective interventions, a better understanding of the pathophysiological mechanisms leading to brain injury and an early identification of babies at high risk for brain injury are required. This study tests the predictivity of traditional and new markers of foetal oxidative stress in relation to neurodevelopmental outcome in 384 newborn infants. The results indicate plasma non protein bound iron as the best early predictive marker of neurodevelopmental outcome, with 100% sensitivity and 100% specificity for good neurodevelopmental outcome at 0-1.16 micro mol/l, and for poor neurodevelopmental outcome at values >15.2 micro mol/l. The number of children with values between 1.16 and 15.2 were 195. Common use of this predictive marker in neonatology units will improve the ability of clinicians to identify those newborn babies who will develop neurodisability.
authors.affiliation: Department of Paediatrics, Obstetrics and Reproductive Medicine, University of Siena, Italy. buonocore@unisi.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Buonocore
authors.forename: Serafina
authors.initials: S
authors.lastname: Perrone
authors.forename: Mariangela
authors.initials: M
authors.lastname: Longini
authors.forename: Patrizia
authors.initials: P
authors.lastname: Paffetti
authors.forename: Piero
authors.initials: P
authors.lastname: Vezzosi
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Gatti
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Bracci
mesh_terms: D001238:Asphyxia Neonatorum / Q000097:blood* / Q000150:complications; D015415:Biomarkers / Q000097:blood; D001925:Brain Damage, Chronic / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D005312:Fetal Blood / Q000737:chemistry; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007501:Iron / Q000097:blood*; D016014:Linear Models; D015997:Neonatal Screening / Q000379:methods; D018384:Oxidative Stress; D010949:Plasma; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
chemical_list: D015415:Biomarkers; D007501:Iron