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Association between newborn screening analytes and hypoxic ischemic encephalopathy.

Lindsay A Wilson1, Deshayne B Fell2,3,4, Steven Hawken1,2,4

  • 1Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa Ontario, Canada.

Scientific Reports
|November 2, 2019
PubMed
Summary

Newborn screening analytes, like amino acids, show altered patterns in infants with hypoxic ischemic encephalopathy (HIE). While not definitive, these findings suggest potential for early HIE diagnosis and management. Further research is needed.

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Area of Science:

  • Neonatal Medicine
  • Biochemistry
  • Public Health

Background:

  • Hypoxic ischemic encephalopathy (HIE) is a significant cause of newborn mortality and morbidity.
  • Early diagnosis and management of HIE are crucial for improving infant outcomes.
  • Current diagnostic methods for HIE may benefit from additional biomarkers.

Purpose of the Study:

  • To investigate differences in newborn screening analyte patterns between infants with and without HIE.
  • To explore the potential utility of routine newborn screening analytes for HIE diagnosis.
  • To identify opportunities for improving early detection and clinical management of HIE.

Main Methods:

  • A population-based study linked newborn screening data with health databases in Ontario (2010-2015).
  • Term infants (≥37 weeks' gestation) were analyzed for HIE diagnosis.
  • Multivariable logistic regression models examined correlations between HIE and screening analytes (acyl-carnitines, amino acids, hemoglobin, etc.).

Main Results:

  • Out of 731,841 term infants, 3,010 were diagnosed with HIE.
  • Clinical variables and hemoglobin values alone or combined did not significantly correlate with HIE diagnosis.
  • Models improved with the addition of acyl-carnitines and amino acids, but diagnostic ability remained moderate.

Conclusions:

  • Altered levels of analytes associated with catabolic stress were observed in infants with HIE.
  • Amino acid and acyl-carnitine profiles may offer potential clinical utility for early HIE diagnosis and management.
  • Further research is essential to validate these findings and explore their application in clinical practice, including cord blood analysis.