Anticonvulsants for preventing mortality and morbidity in full term newborns with perinatal asphyxia

Abstract OBJECTIVE: To explore the capacity of somatosensory evoked potentials (SEP) to assess maturation processes in the development of the nervous system, and the characteristics of SEP in healthy full-term infants and full-term newborns with perinatal asphyxia and their follow up until the age of 14 months. MATERIALS AND METHODS: SEP were studied in 21 healthy full-term infants and 38 full-term newborns with perinatal asphyxia. The children with asphyxia were studied longitudinally until they were 14 months old. To assess the SEP we measured the latency of the P15, N20 and P25 components, the amplitude ratio N20/ P25 and inter-peak intervals P15-N20 and N20-P25. RESULTS: The component that was most typically always found in the SEP recordings of both healthy infants and those with perinatal asphyxia was N20. The mean latency values of P15, N20 and P25 were higher in the children with perinatal asphyxia (p ⋋ 0.001). The SEP amplitude was highly variable (CoV% = 76.6%). The latencies became shorter with age in asphyxia patients aged 0 to 14 months, the shortening being the greatest in the first trimester, while they showed no statistically significant differences in infants aged 6 to 12 months. CONCLUSIONS: SEPs in the neonatal period differ considerably from those of adults and older children in the morphology and longer potential latency, which can be accounted for by the incomplete myelination of nerve fibers. The changes in SEP latency in patients with HIE stages I and II follow the same pattern found in healthy children - latency became shorter with increasing age, which was most pronounced in the first 3 months. SEP latency was found to be correlated with height and age. No differences were found in the latency of potentials between healthy infants and infants with brain hemorrhage. Recording SEP is a sensitive method to assess the CNS in children with perinatal asphyxia and to monitor the maturation of the somatosensory pathway.

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High Urinary Concentrations of Activin A in Asphyxiated Full-Term Newborns with Moderate or Severe Hypoxic Ischemic Encephalopathy

Clinical Chemistry ◽

10.1373/clinchem.2005.062604 ◽

2007 ◽

Vol 53 (3) ◽

pp. 520-522 ◽

Cited By ~ 27

Author(s):

Pasquale Florio ◽

Stefano Luisi ◽

Bashir Moataza ◽

Michela Torricelli ◽

Iskander Iman ◽

...

Keyword(s):

Perinatal Asphyxia ◽

Activin A ◽

Good Prognosis ◽

Full Term ◽

Hypoxic Ischemic Encephalopathy ◽

Promising Tool ◽

Group A ◽

Term Newborns ◽

Group B ◽

Ischemic Encephalopathy

Abstract Background: Hypoxic ischemic encephalopathy (HIE) is a major cause of permanent neurological disabilities in full-term newborns. We measured activin A in urine collected immediately after birth in asphyxiated full-term newborns, and assessed the ability of the measurements to predict the occurrence of perinatal encephalopathy. Methods: We studied 30 infants with perinatal asphyxia and 30 healthy term neonates at the same gestational age. We recorded routine laboratory variables, cranial assessments by standard cerebral ultrasound, and the presence or absence of neurological abnormalities during the first 7 days after birth. Urinary activin A concentrations were measured at first urination and 12, 24, 48, and 72 h after birth. Results: Asphyxiated infants were subdivided as follows: group A (n = 18): no or mild HIE with good prognosis and group B (n = 12): moderate or severe HIE with a greater risk of neurological handicap. Activin A concentrations in urine collected at birth (median collection time at first urination <2 h) and at 12, 24, 48, and 72 h from birth were significantly (P <0.0001) higher in asphyxiated newborns with moderate or severe HIE (Group B) than in those with absent of mild HIE (group A) and controls. Concentrations did not differ between group A and controls. Activin A concentrations were >0.08 μg/L at first urination in 10 of 12 patients with moderate or severe HIE but in none of 18 patients with no or mild HIE. Conclusions: Activin A measurements in urine soon after birth may be a promising tool to identify which asphyxiated infants are at risk of neurological sequelae.

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The role of biochemical markers as early indicators of cardiac damage and prognostic parameters of perinatal asphyxia

Vojnosanitetski pregled ◽

10.2298/vsp1402149s ◽

2014 ◽

Vol 71 (2) ◽

pp. 149-155 ◽

Cited By ~ 2

Author(s):

Aleksandra Simovic ◽

Jovan Kosutic ◽

Sergej Prijic ◽

Jasmina Knezevic ◽

Ana Vujic ◽

...

Keyword(s):

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Cardiac Troponin ◽

Troponin I ◽

Perinatal Asphyxia ◽

Cardiac Troponin I ◽

Full Term ◽

C Reactive Protein ◽

Reactive Protein ◽

Term Newborns

Background/Aim. In recent years, the focus of interest of the scientific community is the application of heart markers as early indicators and prognostic parameters of perinatal asphyxia (PA). The aim of this study was to evaluate the significance of clinical application of heart markers in term newborns with perinatal asphyxia. Methods. During a 3- year period we analyzed 91 full-term newborns (55 with and 36 without perinatal asphyxia). In all the subjects within the first 24-48 h after birth, we simultaneously determined serum concentrations of cardiac troponin I, brain natriuretic peptide, MB fraction of creatine kinase (CK-MB) and Creactive protein. Results. In the group of full-term neonates with PA significantly higher levels of cardiac troponinI (p = 0.000), CK-MB fraction (p = 0.000), brain natriuretic peptide (p = 0.003) and C-reactive protein (p = 0.017) were found, compared to the group of healthy full-term newborns. In merged group (n = 91) cardiac troponin I level correlated with the fifth minute Apgar score (r = - 0.637, p = 0.000) and the serum lactate concentration in the first 12h after birth (r = 0.529, p = 0.000). Early increase in cardiac troponin I > 0.135 ?g/L predicted the risk of death with the sensitivity of 84.6% and specificity of 85.9%, while the increase in CK-MB fraction, brain natriuretic peptide and C-reactive protein did not have a predictive value with respect to a mortality outcome. Conclusion. Among the tested cardiac markers, cardiac troponin I is the most sensitive and the only reliable early predictor of mortality in fullterm neonates with perinatal asphyxia.

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