title: PGE-metabolite levels in CSF correlate to HIE score and outcome after perinatal asphyxia.
abstract: OBJECTIVE
  Acute anoxic exposure rapidly increases prostaglandin E2 (PGE2 ) production and release in neonatal mice brains. We hypothesize that PGE2 is released in human cerebrospinal fluid (CSF) during perinatal asphyxia and that it might be used as a biomarker for perinatal asphyxia.
  
  
  METHODS
  In full-term infants with lumbar puncture performed within 72 h of birth (n = 35), CSF was analysed for prostaglandin E2 metabolite (PGEM) using an enzyme immunoassay. Term infants with suspected but unverified infections were used as controls (n = 11). Hypoxic-ischaemic encephalopathy (HIE) was classified as mild, moderate or severe (HIE I-III). Neurological assessment of surviving patients was performed at 18 months of age.
  
  
  RESULTS
  Prostaglandin E2 metabolite levels correlated to a low Apgar score at 5 min (p < 0.01) and 10 min (p < 0.01), a low pH (p < 0.001) and HIE score (p < 0.05). The HIE-III cases (n = 7) had significantly higher PGEM levels compared with both controls and the HIE-I group (n = 8). Irrespective of HIE grade, patients with adverse or fatal outcome had higher PGEM values compared with controls and asphyxiated infants with normal outcome (p < 0.05).
  
  
  CONCLUSIONS
  PGE2 is released during anoxic events in newborn infants, and PGEM may be useful as a biomarker for estimating degree of insult and predicting long-term outcome after perinatal asphyxia.
authors.affiliation: Department of Women's and Children's Health, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Björk
authors.forename: Kristin
authors.initials: K
authors.lastname: Leifsdottir
authors.forename: Sipra
authors.initials: S
authors.lastname: Saha
authors.forename: Eric
authors.initials: E
authors.lastname: Herlenius
mesh_terms: D001238:Asphyxia Neonatorum / Q000134:cerebrospinal fluid*; D016022:Case-Control Studies; D015232:Dinoprostone / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000134:cerebrospinal fluid*; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D012372:ROC Curve; D012720:Severity of Illness Index
chemical_list: D015232:Dinoprostone
keywords: Asphyxia; Biomarker; Cerebrospinal fluid; Hypoxic-ischaemic encephalopathy; Inflammation; Prostaglandin E2