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Non protein bound iron as early predictive marker of neonatal brain damage
Giuseppe Buonocore1, Serafina Perrone, Mariangela Longini
1Department of Paediatrics, Obstetrics and Reproductive Medicine, University of Siena, Italy. buonocore@unisi.it
Insights
This study identified plasma non-protein bound iron as a highly accurate early marker for predicting neurodevelopmental outcomes in newborns. This finding can help clinicians identify infants at risk for brain injury and neurodisability.
Area of Science:
- Neonatal Medicine
- Neuroscience
- Biochemistry
Background:
- Birth asphyxia affects millions of newborns annually, leading to significant mortality and long-term neurodevelopmental issues.
- Effective interventions require a deeper understanding of brain injury mechanisms and early identification of at-risk infants.
- Predictive markers for fetal oxidative stress are crucial for assessing neurodevelopmental outcomes.
Purpose of the Study:
- To evaluate the predictive accuracy of traditional and novel fetal oxidative stress markers for neurodevelopmental outcomes in newborns.
- To identify the most effective early predictive marker for identifying infants at risk of neurodevelopmental impairment.
Main Methods:
- A cohort of 384 newborn infants was studied.
- The predictivity of various markers of fetal oxidative stress was assessed against neurodevelopmental outcomes.
- Plasma non-protein bound iron levels were analyzed as a key predictive marker.
Main Results:
- Plasma non-protein bound iron demonstrated high predictive accuracy for neurodevelopmental outcomes.
- 100% sensitivity and specificity were observed for good neurodevelopmental outcome at levels of 0-1.16 micro mol/l.
- 100% sensitivity and specificity were observed for poor neurodevelopmental outcome at levels >15.2 micro mol/l.
Conclusions:
- Plasma non-protein bound iron is the optimal early predictive marker for neurodevelopmental outcomes in newborns.
- Routine use of this marker in neonatology can significantly improve the identification of infants at risk for neurodisability.
- Early identification facilitates timely interventions to mitigate the impact of birth asphyxia-related brain injury.
Abstract:
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 micro mol/l, and for poor neurodevelopmental outcome at values >15.2 micro mol/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.