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Updated: Sep 14, 2026
A Piglet Model of Neonatal Hypoxic-Ischemic Encephalopathy
Published on: May 16, 2015
Changes in lactate dehydrogenase are associated with central gray matter lesions in newborns with hypoxic-ischemic
Sook Kyung Yum1, Cheong-Jun Moon1, Young-Ah Youn1
1a Division of Neonatology , Department of Pediatrics, College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea.
Insights
Changes in serum lactate dehydrogenase (LDH) can predict neurological outcomes in infants with hypoxic-ischemic encephalopathy (HIE). This study found that the percentage change in LDH levels was significantly higher in infants with brain lesions, suggesting LDH as a potential biomarker.
Area of Science:
- Neonatal neurology
- Biomarker discovery
- Neuroimaging
Background:
- Hypoxic-ischemic encephalopathy (HIE) poses a significant risk for neurological impairment in infants.
- Predicting neurodevelopmental outcomes in HIE is crucial for timely intervention.
- Brain magnetic resonance imaging (MRI) is a key tool for assessing HIE-related brain injury.
Purpose of the Study:
- To evaluate the predictive value of serum lactate dehydrogenase (LDH) levels for neurological prognosis in infants with HIE.
- To assess the relationship between LDH levels and brain MRI findings indicative of hypoxic-ischemic injury.
- To determine if LDH can serve as a biomarker for neurodevelopmental outcomes.
Main Methods:
- Retrospective review of medical records for infants diagnosed with HIE.
- Measurement of serum LDH levels on day 1 (LDH1) and day 3 (LDH3) post-birth.
- Analysis of brain MRI scans to identify hypoxic-ischemic lesions, particularly in the central gray matter.
- Calculation of the percentage change in LDH (ΔLDH%) and its correlation with lesion presence.
Main Results:
- Of 92 infants with HIE, 56.5% showed hypoxic-ischemic lesions on MRI, with 40.4% having central gray matter lesions.
- The percentage change in serum LDH (ΔLDH%) was significantly higher in infants with central gray matter lesions compared to those without (36.9% vs. 6.6%, p=0.006).
- Specific cutoffs for ΔLDH demonstrated good predictive values for identifying infants with central gray matter lesions, with a relative risk of 5.57 (p=0.001).
Conclusions:
- Changes in serum LDH levels may serve as a valuable, non-invasive biomarker for predicting neurodevelopmental prognosis in infants with HIE.
- Monitoring ΔLDH% could aid clinicians in identifying infants at higher risk of adverse neurological outcomes.
- Further research is warranted to validate LDH as a prognostic tool in HIE.
Purpose:
Biomarkers may predict neurological prognosis in infants with hypoxic-ischemic encephalopathy (HIE). We evaluated the relationship between serum lactate dehydrogenase (LDH) and brain magnetic resonance imaging (MRI), which predicts neurodevelopmental outcomes, in order to assess whether LDH levels are similarly predictive.
Materials And Methods:
Medical records were reviewed for infants with HIE and LDH levels were assessed on the first (LDH1) and third (LDH3) days following birth. Receiver operating characteristic curves were obtained in relation to central gray matter hypoxic-ischemic lesions.
Results:
Of 92 patients, 52 (56.5%) had hypoxic-ischemic lesions on brain MRI, and 21 of these infants (40.4%) had central gray matter lesions. LDH1 and LDH3 did not differ; however, the percentage change (ΔLDH%) was significantly higher in infants with central gray matter lesions (36.9% versus 6.6%, p = 0.006). With cutoffs of 187 (IU/L, ΔLDH) and 19.4 (%, ΔLDH%), the sensitivity, specificity, positive predictive value and negative predictive value were 71.4, 69.0, 40.5 and 89.1%, respectively. The relative risk was 5.57 (p = 0.001).
Conclusion:
Changes in serum LDH may be a useful biomarker for predicting future neurodevelopmental prognosis in infants with HIE.
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