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Observational Study
. 2014 Jun;75(6):781-7.
doi: 10.1038/pr.2014.41. Epub 2014 Apr 10.

Elevated blood levels of inflammation-related proteins are associated with an attention problem at age 24 mo in extremely preterm infants

T Michael O'Shea  1 , Robert M Joseph  2 , Karl C K Kuban  3 , Elizabeth N Allred  4 , Janice Ware  5 , Taryn Coster  5 , Raina N Fichorova  6 , Olaf Dammann  7 , Alan Leviton  4 ; ELGAN Study Investigators
Collaborators, Affiliations
Observational Study

Elevated blood levels of inflammation-related proteins are associated with an attention problem at age 24 mo in extremely preterm infants

T Michael O'Shea et al. Pediatr Res. 2014 Jun.

Abstract

Background: Extremely preterm birth is associated with subsequent behavioral problems. We hypothesized that perinatal systemic inflammation, a risk factor for cerebral white matter injury and cognitive impairment, is associated with behavior problems observed at 2 y.

Methods: In a cohort of 600 children born before 28 wk gestation, we measured 25 inflammation-related proteins in blood collected on postnatal days 1, 7, and 14, and identified behavior problems using parent responses to the Child Behavior Checklist for Ages 1.5-5 (CBCL/1.5-5) at 2 y of age. A persistent or recurrent protein elevation was defined as a concentration in the highest quartile (for gestational age and postnatal age) on at least 2 d ~1 wk apart. Behavior problems were defined by CBCL/1.5-5 subscale scores at or above the 93 rd percentile.

Results: A single-day elevation of intercellular adhesion molecule-3 was associated with an increased risk of an attention problem, as were persistent or recurrent elevations of myeloperoxidase, interleukin-6, tumor necrosis factor-RI, interleukin-8, intercellular adhesion molecule-3, vascular endothelial growth factor-R1, and vascular endothelial growth factor-R2. These associations persisted among infants without white matter injury and cognitive impairment.

Conclusion: Among children born extremely prematurely, recurrent, or persistent elevations of inflammation-related proteins in blood during in the first two postnatal weeks are associated with an attention problem at age 2 y.

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Conflict of interest statement

Conflict of interest statement:

None of the authors has any financial issue or conflict of interest to disclose

References

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