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. 2021 Mar 29:9:624652.
doi: 10.3389/fped.2021.624652. eCollection 2021.

Association of Routinely Measured Proinflammatory Biomarkers With Abnormal MRI Findings in Asphyxiated Neonates Undergoing Therapeutic Hypothermia

Maria Ruhfus  1 , Stamatios Giannakis  2 , Mona Markus  2 , Anja Stein  1 , Thomas Hoehn  2 , Ursula Felderhoff-Mueser  1 , Hemmen Sabir  1   3   4
Affiliations

Association of Routinely Measured Proinflammatory Biomarkers With Abnormal MRI Findings in Asphyxiated Neonates Undergoing Therapeutic Hypothermia

Maria Ruhfus et al. Front Pediatr. .

Abstract

Background: The neuroprotective treatment effect of therapeutic hypothermia (TH) following perinatal asphyxia may be negatively influenced by neonatal sepsis and concomitant inflammation. We aimed to correlate routinely used blood biomarkers for perinatal sepsis in cooled asphyxiated newborns with MRI findings. Methods: Perinatal data was retrospectively collected from 67 cooled asphyxiated newborns. Levels of C-reactive protein (CRP), white blood cells and platelets were analyzed before, during and after TH. Interleukin-6 blood levels were analyzed before initiation of TH. Magnetic resonance imaging (MRI) on postnatal day 5-7 was used defining short-term outcome. Adverse outcome was defined as death or adverse MRI findings. Amplitude-integrated electroencephalography (aEEG) was additionally analyzed and correlated with short-term MRI outcome. Results: Forty-nine newborns had favorable short-term MRI outcome. Perinatal data referring to perinatal sepsis did not differ significantly between groups. IL-6 levels before initiation of TH and CRP levels on day three and after TH were significantly higher in newborns with adverse short-term MRI outcome. Males with adverse short-term MRI outcome had significantly increased CRP values at the end of the cooling phase. aEEG strongly correlated with short-term MRI outcome. Conclusion: Routinely used blood biomarkers may be helpful early identifying newborns at high risk of unfavorable outcome and in need of close neurodevelopmental follow-up.

Keywords: aEEG; asphyxia; biomarker; cooling; newborn; outcome.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
IL-6 values before initiation of therapeutic hypothermia: IL-6 values were significantly higher in newborns with death or adverse MRI findings, defined as BG/W score > 2. Data presented as mean ± standard deviation (SD), *p < 0.05.
Figure 2
Figure 2
CRP levels before, during and after therapeutic hypothermia. (A) CRP levels were higher in newborns with death or adverse MRI findings, defined as BG/W score > 2. (B) Males had increased CRP values compared to females. Males with death or adverse MRI findings had significantly increased CRP values at the end of the cooling phase and after rewarming. Data presented as mean ± standard deviation (SD), *p < 0.05.
Figure 3
Figure 3
Leucocyte and Platelet levels during therapeutic hypothermia. (A) Leucocyte levels were decreased after initiation of TH in both groups, however leucocytes were significantly higher in newborns with death or adverse MRI findings, defined as BG/W score > 2, after rewarming. (B) Platelet counts were significantly higher at the end of TH and after rewarming in newborns with death or adverse MRI findings. Data presented as mean ± standard deviation (SD), *p < 0.05.
Figure 4
Figure 4
Receiver operating characteristic curves.
See this image and copyright information in PMC

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