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

2007 ◽  
Vol 53 (3) ◽  
pp. 520-522 ◽  
Author(s):  
Pasquale Florio ◽  
Stefano Luisi ◽  
Bashir Moataza ◽  
Michela Torricelli ◽  
Iskander Iman ◽  
...  

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.

2004 ◽  
Vol 50 (12) ◽  
pp. 2386-2389 ◽  
Author(s):  
Pasquale Florio ◽  
Stefano Luisi ◽  
Matteo Bruschettini ◽  
Dariusz Grutzfeld ◽  
Anna Dobrzanska ◽  
...  

PEDIATRICS ◽  
1996 ◽  
Vol 97 (1) ◽  
pp. 151-152
Author(s):  
Nadia Badawi ◽  
Jennifer J. Kurinczuk ◽  
Eve Blair ◽  
John Keogh ◽  
Fiona Stanley

We read with interest the article by Cordes et al.1 This article raises an important issue concerning assumptions made with respect to the significance of intrapartum and neonatal observations. The population of infants studied was 54 full-term newborns born after uneventful pregnancies and diagnosed as having acute hypoxic-ischemic encephalopathy (HIE) that was intrapartum in origin. The underlying assumption of this diagnosis was that if there is no obvious antenatal cause of abnormal neonatal neurological signs, then any suboptimal intrapartum observation identifies the pathology as being intrapartum in origin.


PEDIATRICS ◽  
1994 ◽  
Vol 93 (5) ◽  
pp. 703-707
Author(s):  
Isabel Cordes ◽  
Elke H. Roland ◽  
Alan Hill ◽  
Brian A. Lupton

The development of microcephaly after significant hypoxic-ischemic cerebral injury in the full-term newborn has major prognostic significance. However, the onset of microcephaly in this context may be delayed more than 12 months. Objectives. To determine whether serial head circumference measurements and decreased rate of head growth in asphyxiated full-term newborns during the first few months of life may predict the development of eventual microcephaly. Methodology. Serial head circumference measurements at 4, 8, and 18 months of age were obtained in 54 full-term newborns who had acute, hypoxic-ischemic encephalopathy. The rate of head growth was determined on the basis of changes in head circumference ratios which are calculated as follows: actual head circumference/mean head circumference for age x 100%. Head circumference ratios were correlated with severity of newborn encephalopathy and outcome at 18 months. Results. A decrease in head circumference ratios of >3.1% between birth and 4 months of age was highly predictive of the eventual development of microcephaly before 18 months (sensitivity 90%, specificity 85%). Conclusions. These data demonstrate that serial head circumference measurements during the first 4 months of life and calculation of decreased rate of head growth in full-term newborns with hypoxic-ischemic encephalopathy may predict microcephaly before its actual occurrence.


2017 ◽  
Vol Volume 13 ◽  
pp. 2255-2256
Author(s):  
Usama M. Alkholy ◽  
Nermin Abdalmonem ◽  
Ahmed Zaki ◽  
Yasser F Ali ◽  
Soma Mohamed ◽  
...  

Medicina ◽  
2013 ◽  
Vol 49 (1) ◽  
pp. 8 ◽  
Author(s):  
Aušrelė Kudrevičienė ◽  
Saulius Lukoševičius ◽  
Jūratė Laurynaitienė ◽  
Vitalija Marmienė ◽  
Rasa Tamelienė ◽  
...  

The aim of this article was to review the studies on diagnostic and prognostic value of radiological investigations (cranial sonography, Doppler ultrasonography, and magnetic resonance imaging) in the detection of hypoxic-ischemic brain injuries in full-term newborns. Materials and Methods. A systematic search of studies on the diagnostic and prognostic possibilities of radiological investigations for the detection of hypoxic-ischemic injuries in full-term newborns was performed. Results. A total of 13 prospective and 4 retrospective studies that analyzed the incidence of hypoxic-ischemic cerebral injuries, determined by means of cranial sonography, Doppler sonography, and magnetic resonance imaging, and associations with the stages of hypoxic-ischemic encephalopathy and long-term neurodevelopmental outcomes were included in this systematic review. Conclusions. Magnetic resonance imaging detects lesions in 75%–100% of cases. Magnetic resonance imaging performed at the age of 7–11 days demonstrated a high sensitivity (100%) and negative predictive value (100%) to predict unfavorable outcomes at 4 years of age. In newborns with hypoxic-ischemic encephalopathy, substantial cerebral hemodynamic alterations are detected after birth. The sensitivity and negative predictive value of cerebral blood flow velocities (peak systolic flow velocity, end-diastolic flow velocity) changes at 12±2 hours of age to predict the severity of hypoxic-ischemic encephalopathy and unfavorable outcomes at 18 months of age were found to be high (90% and 94%, respectively). A low resistive index (<0.56) at the age of 1–3 days had a specificity of 95% to predict unfavorable outcomes at 3 years of age. The data on the diagnostic and prognostic potential of cranial sonography are limited scarce and contrary.


2017 ◽  
Vol Volume 13 ◽  
pp. 2133-2139 ◽  
Author(s):  
Usama M. Alkholy ◽  
Nermin Abdalmonem ◽  
Ahmed Zaki ◽  
Yasser F Ali ◽  
Soma Mohamed ◽  
...  

2021 ◽  
Author(s):  
Marc Paul O'Sullivan ◽  
Niamh Denihan ◽  
Klaudia Sikora ◽  
Mikael Finder ◽  
Caroline Ahearne ◽  
...  

Abstract Background Activin A protein and its receptor ACVR2B have been considered viable biomarkers for the diagnosis of hypoxic–ischemic encephalopathy (HIE). This study aimed to assess umbilical cord blood (UCB) levels of Activin A and Acvr2b messenger RNA (mRNA) as early biomarkers of mild and moderate HIE and long-term neurodevelopmental outcome. Methods One-hundred and twenty-six infants were included in the analyses from the BiHiVE2 cohort, a multi-center study, recruited in Ireland and Sweden (2013 to 2015). UCB serum Activin A and whole blood Acvr2b mRNA were measured using enzyme-linked immunosorbent assay and quantitative polymerase chain reaction, respectively. Results Activin A analysis included 101 infants (controls, n = 50, perinatal asphyxia, n = 28, HIE, n = 23). No differences were detected across groups (p = 0.69). No differences were detected across HIE grades (p = 0.12). Acvr2b mRNA analysis included 67 infants (controls, n = 22, perinatal asphyxia, n = 23, and HIE, n = 22), and no differences were observed across groups (p = 0.75). No differences were detected across HIE grades (p = 0.58). No differences were detected in neurodevelopmental outcome in infants followed up to 18 to 36 months in serum Activin A or in whole blood Acvr2b mRNA (p = 0.55 and p = 0.90, respectively). Conclusion UCB Activin A and Acvr2b mRNA are not valid biomarkers of infants with mild or moderate HIE; they are unable to distinguish infants with HIE or infants with poor neurodevelopmental outcomes.


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