Related Experiment Videos
Early biochemical indicators of hypoxic-ischemic encephalopathy after birth asphyxia
1Department of Neonatology, Institute of Laboratory Medicine, Charité University Hospital, Humboldt University Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. nicole.nagdyman@charite.de
Insights
Early detection of Hypoxic-Ischemic Encephalopathy (HIE) in newborns is crucial. Elevated serum markers like CK-BB and S-100 within 2 hours after birth can reliably indicate moderate to severe HIE, aiding timely neuroprotective interventions.
Area of Science:
- Biochemistry
- Neonatal Medicine
- Neurology
Background:
- Hypoxic-ischemic encephalopathy (HIE) is a serious condition in newborns resulting from perinatal asphyxia.
- Early identification of brain damage is essential for initiating timely neuroprotective therapies.
Purpose of the Study:
- To evaluate the efficacy of serum brain-specific biochemical markers, including creatine kinase-BB (CK-BB) and protein S-100, as early indicators of HIE in newborns.
- To determine the predictive value of these markers in identifying moderate to severe HIE.
Main Methods:
- Serum concentrations of CK-BB, protein S-100, and neuron-specific enolase were measured in asphyxiated and control infants at birth and at 2, 6, 12, and 24 hours.
- Statistical analysis was performed to compare marker levels between groups and assess predictive values.
Main Results:
- Elevated serum CK-BB and protein S-100 levels were observed as early as 2 hours after birth in infants with moderate to severe HIE compared to controls.
- A combination of protein S-100 (cutoff 8.5 microg/L) and CK-BB (cutoff 18.8 U/L) at 2 hours showed high predictive value (83%) and specificity (95%) for moderate/severe HIE.
- Cord blood pH and base deficit further improved the predictive accuracy of these markers.
Conclusions:
- Serum protein S-100 and CK-BB concentrations measured 2 hours after birth are reliable early indicators of moderate and severe HIE.
- These biochemical markers facilitate prompt initiation of neuroprotective treatments in at-risk newborns.
Abstract:
Hypoxic-ischemic encephalopathy (HIE) after perinatal asphyxia is a condition in which serum concentrations of brain-specific biochemical markers may be elevated. Neuroprotective interventions in asphyxiated newborns require early indicators of brain damage to initiate therapy. We examined brain-specific creatine kinase (CK-BB), protein S-100, and neuron-specific enolase in cord blood and 2, 6, 12, and 24 h after birth in 29 asphyxiated and 20 control infants. At 2 h after birth, median (quartiles) serum CK-BB concentration was 10.0 U/L (6.0-13.0 U/L) in control infants, 16.0 U/L (13.0-23.5 U/L) in infants with no or mild HIE, and 46.5 U/L (21.4-83.0 U/L) in infants with moderate or severe HIE. Serum protein S-100 was 1.6 microg/L (1.4-2.5 microg/L) in control infants, 2.9 microg/L (1.8-4.7 microg/L) in asphyxiated infants with no or mild HIE, and 17.0 microg/L (3.2-34.1 microg/L) in infants with moderate or severe HIE 2 h after birth. No significant difference was detectable in serum neuron-specific enolase between infants with no or mild and moderate or severe HIE 2 and 6 h after birth. A combination of serum protein S-100 (cutoff value, 8.5 microg/L) and CK-BB (cutoff value, 18.8 U/L) 2 h after birth had the highest predictive value (83%) and specificity (95%) of predicting moderate and severe HIE. Cord blood pH (cutoff value, <6.9) and cord blood base deficit (cutoff value, >17 mM) increase the predictive values of protein S-100 and CK-BB. We conclude that elevated serum concentrations of protein S-100 and CK-BB reliably indicate moderate and severe HIE as early as 2 h after birth.