Non protein bound iron as early predictive marker of neonatal brain damage

• Published in: Brain (London, England : 1878) England : 1878), 2003-05, Vol.126 (5), p.1224-1230
• Main Authors: Buonocore, Giuseppe, Perrone, Serafina, Longini, Mariangela, Paffetti, Patrizia, Vezzosi, Piero, Gatti, Maria Gabriella, Bracci, Rodolfo
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; AOPP = advanced oxidative protein products; Asphyxia Neonatorum - blood; Asphyxia Neonatorum - complications; Biological and medical sciences; Biomarkers - blood; Brain Damage, Chronic - blood; Brain Damage, Chronic - diagnosis; Brain Damage, Chronic - etiology; brain injury; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Fetal Blood - chemistry; free radicals; Humans; Hx = Hypoxanthine; infant; Infant, Newborn; Infant, Premature; Intensive care medicine; iron; Iron - blood; Linear Models; Medical sciences; Neonatal Screening - methods; newborn; NPBI = non protein bound iron; NRBC = nucleated red blood cell; Oxidative Stress; Plasma; Predictive Value of Tests; Prospective Studies; ROC curve = receiver operating characteristic curve; Sensitivity and Specificity; Statistics, Nonparametric; TH = total hydroperoxides
• ISSN: 0006-8950; 1460-2156
• DOI: 10.1093/brain/awg116

Of the approximately 130 million births worldwide each year, four million infants will suffer from birth asphyxia and, of these, one million will die and a similar number will develop serious sequelae. Before being able to develop effective interventions, a better understanding of the pathophysiological mechanisms leading to brain injury and an early identification of babies at high risk for brain injury are required. This study tests the predictivity of traditional and new markers of foetal oxidative stress in relation to neurodevelopmental outcome in 384 newborn infants. The results indicate plasma non protein bound iron as the best early predictive marker of neurodevelopmental outcome, with 100% sensitivity and 100% specificity for good neurodevelopmental outcome at 0–1.16 µmol/l, and for poor neurodevelopmental outcome at values >15.2 µmol/l. The number of children with values between 1.16 and 15.2 were 195. Common use of this predictive marker in neonatology units will improve the ability of clinicians to identify those newborn babies who will develop neurodisability.