Identifying Early Diagnostic Biomarkers Associated with Neonatal Hypoxic-Ischemic Encephalopathy

Background: Identifying an effective method for the early diagnosis of neonatal hypoxic-ischemic encephalopathy (HIE) would be beneficial for effective therapies. Methods: We studied blood biomarkers before 6 h after birth to correlate the degree of neonatal HIE. A total of 80 patients were divided...

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Bibliographic Details
Published in:Diagnostics (Basel) 2021-05, Vol.11 (5), p.897
Main Authors: Lee, Inn-Chi, Wong, Swee-Hee, Wang, Xing-An, Yu, Chin-Sheng
Format: Article
Language:English
Subjects:
biomarker
Biomarkers
Brain
Creatinine
Electroencephalography
Hemorrhage
Hypothermia
Hypoxia
hypoxic-ischemic encephalopathy
Ischemia
lactate
Magnetic resonance imaging
Mortality
MRI
newborn
Newborn babies
Patients
Thrombosis
Urine
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Summary:Background: Identifying an effective method for the early diagnosis of neonatal hypoxic-ischemic encephalopathy (HIE) would be beneficial for effective therapies. Methods: We studied blood biomarkers before 6 h after birth to correlate the degree of neonatal HIE. A total of 80 patients were divided into group 1 (mild HIE) and group 2 (moderate or severe HIE). Then, 42 patients from group 2 received hypothermia therapy and were further divided into group 3 (unremarkable or mild MRI results) and group 4 (severe MRI results). Results: Between groups 1 and 2, lactate, creatinine, white blood cells, and lactate dehydrogenase (LDH) were significantly different. Between groups 3 and 4, lactate, prothrombin time, and albumin were significantly different. Sarnat staging was based on our observation that more than 45 mg/dL of lactate combined with more than 1000 U/L of LDH yielded the highest positive predictive value (PPV) (95.7%; odds ratio, 22.00), but a low negative predictive value (NPV) for moderate or severe HIE. Using more than 45 mg/dL of lactate yielded the highest NPV (71.4%) correlated with moderate or severe HIE. Conclusions: Lactate combined with LDH before 6 h after birth yielded a high PPV. Using combined biomarkers to exclude mild HIE, include moderate or severe HIE, and initialize hypothermia therapy is feasible.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics11050897