Value of biochemical markers for outcome in term infants with asphyxia.
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.
Tekgul
Hasan
H
Department of Pediatrics, Division of Pediatric Neurology, Ege University Hospital, Izmir, Turkey.
Yalaz
Mehmet
M
Kutukculer
Necil
N
Ozbek
Sureyya
S
Kose
Timur
T
Akisu
Mete
M
Kultursay
Nilgun
N
Gokben
Sarenur
S
D001238:Asphyxia Neonatorum / Q000175:diagnosis* / Q000378:metabolism* / Q000628:therapy; D015415:Biomarkers; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine*; D003422:Critical Care; D006801:Humans; D007231:Infant, Newborn; D015850:Interleukin-6 / Q000097:blood* / Q000134:cerebrospinal fluid; D010751:Phosphopyruvate Hydratase / Q000097:blood* / Q000134:cerebrospinal fluid; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014527:Uric Acid / Q000652:urine*
D015415:Biomarkers; D015850:Interleukin-6; D014527:Uric Acid; D003404:Creatinine; D010751:Phosphopyruvate Hydratase