Lancet: Can cord blood predict cerebral palsy and death risk in preterm infants?

April 04, 2019 Source: Biological Exploration

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It is well known that premature infants exposed to infection in the amniotic cavity can cause neonatal risk of short-term or long-term cerebral palsy. However, the specificity of the fetus' response to infection determines that not all premature fetuses in an inflammatory environment will have an unfortunate outcome. So, what is the key to getting sick in premature babies?

Recently, researchers at the University of Illinois at Chicago found that some premature babies were born without haptoglobin, a protein in blood cells, with a higher chance of cerebral hemorrhage, cerebral palsy and death . This finding suggests that the lack of this protein can serve as a potential biomarker to enhance surveillance or other preventive measures for such preterm infants.

The findings were published in "Lancet" magazine "EClinical Medicine." The researchers analyzed data stored in a previous clinical trial at the National Institutes of Health and newborn cord blood samples.

Https://doi.org/10.1016/j.eclinm.2019.03.009

Dr. Catalin Buhimschi and Dr. Irina Buhimschi from UIC Medical School led the study. They analyzed cord blood samples from 921 newborns to determine if haptoglobin is associated with adverse outcomes in the uterus that infect the fetus. Studies have shown that intrauterine infections can cause about 30% of preterm births.

Data analysis found that premature infants who had been exposed to inflammation and lacked binding proteins were more likely to die within 1 year or develop cerebral palsy within 2 years compared with premature infants who had not been exposed to inflammation. In addition, they have a higher incidence of cerebral hemorrhage.

Even if potential confounders such as birth weight, gestational age, fetal gender, or other treatments (such as magnesium sulfate for neuroprotection) are evaluated, these conclusions still exist.

Dr. Catalin, author of the paper and a professor of obstetrics and gynaecology at the University of Chicago, said: "Our study provides strong evidence that there is no hemoglobin in premature infants exposed to inflammation, and the risk of complications such as cerebral hemorrhage, cerebral palsy and even death increases. The potential protective effect of haptoglobin on short-term and long-term adverse prognosis in neonates is highlighted, and suggests that the protein may be an important marker of neurological damage and clinical intervention ."

The researchers conducted a number of studies on haptoglobin in premature babies, but this is the first time that a large number of representative participants have been included.

Irina Buhimschi, co-author of the paper and professor of obstetrics and gynaecology, said that the maternal-feminal medicine profession needs this individualized approach to understand the risks of specific newborn groups.

In the study, the researchers developed a new method for detecting very low levels of binding proteins, because the protein reached adult levels by the age of one year.

“New mothers and babies are particularly complicated, and we can't generalize all premature babies,” Irina Buhimschi points out. “This study is also particularly fascinating because haptoglobin is a known protein, but until now, it still Not applied in this way."

Catalin Buhimschi concluded, “ A simple test of cord blood after delivery can help doctors develop personalized care plans for some high-risk newborns .”

references:

Can a protein in cord blood predict risk of death, cerebral palsy in preterm infants?

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