Early Inflammatory Measures and Neurodevelopmental Outcomes in Preterm Infants
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Published on: November 20, 2015
Marliese Dion Nist1, Abigail B Shoben, Rita H Pickler
1Marliese Dion Nist, PhD, RNC-NIC, is Postdoctoral Scholar, The Ohio State University College of Nursing, Columbus. Abigail B. Shoben, PhD, is Associate Professor, Division of Biostatistics, The Ohio State University College of Public Health, Columbus. Rita H. Pickler, PhD, RN, FAAN, is FloAnn Sours Easton Endowed Professor of Child and Adolescent Health, The Ohio State University College of Nursing, Columbus.
Insights
Early inflammation may predict neurodevelopment in preterm infants, but its effects vary by infant gender and race. Further research is needed to understand these demographic differences for targeted interventions.
Area of Science:
- Neonatal Medicine
- Neuroscience
- Immunology
Background:
- Inflammation is a potential predictor of long-term neurodevelopment in preterm infants.
- Identifying specific inflammatory biomarkers is crucial for predicting infant outcomes.
Purpose of the Study:
- To identify associations between early inflammation markers and neurodevelopment in very preterm infants.
- To explore how infant gender and race influence the relationship between inflammation and neurodevelopment.
Main Methods:
- Secondary analysis of a randomized controlled trial involving preterm infants (<33 weeks postmenstrual age).
- Plasma cytokine, chemokine, and growth factor analysis via multiplex assay.
- Neurobehavioral assessment at discharge and neurodevelopmental assessment at 6 months corrected age using standardized scales.
Main Results:
- Inconsistent associations between single-time point inflammation measures and neurodevelopment in the total sample.
- Significant interactions revealed that inflammatory effects on neurobehavior and neurodevelopment differed by infant gender and race.
Conclusions:
- Early single-time point inflammation measures may not be sufficient to predict neurodevelopment in all preterm infants.
- Infant gender and race are important demographic factors that modify the impact of inflammation on neurodevelopment.
- These demographic differences should be considered in future research and interventions for preterm infants.
Background:
Inflammation may be an important predictor of long-term neurodevelopment in preterm infants. The identification of specific inflammatory biomarkers that predict outcomes is an important research goal.
Objectives:
The purpose of this analysis was to identify associations between an early measure of inflammation and neurodevelopment in very preterm infants and to identify differences in the relationship between inflammation and neurodevelopment based on infant gender and race.
Methods:
We conducted a secondary analysis of data from a randomized controlled trial of a caregiving intervention for preterm infants born less than 33 weeks postmenstrual age. Plasma was collected with a clinically indicated laboratory draw by neonatal intensive care unit nurses and analyzed by multiplex assay for cytokines, chemokines, and growth factors. Neurobehavior was assessed by research nurses at the time of discharge from the neonatal intensive care unit using the motor development and vigor and alertness/orientation clusters from the Neurobehavioral Assessment of the Preterm Infant. Neurodevelopment was assessed at 6 months corrected age by the developmental specialist in the hospital's neonatal follow-up clinic using the Bayley Scales of Infant Development, Third Edition. We used linear regressions to estimate the effect of cytokine levels on neurodevelopment and allowed the effects to differ by infant gender and race.
Results:
In a sample of 62 preterm infants with discharge neurobehavioral assessments and a sample of 40 preterm infants with 6-month neurodevelopmental assessments, we found inconsistent associations between single-time point inflammatory measures and neurobehavior or neurodevelopment in analyses of the total sample. However, regressions with interactions revealed effects for multiple inflammatory measures on early neurobehavior and neurodevelopment that differed by infant gender and race.
Discussion:
Although early single-time point measures of inflammation may be insufficient to predict neurodevelopment for all preterm infants, the effect of inflammation appears to differ by infant gender and race. These demographic factors may be important considerations for future studies of inflammation and neurodevelopment as well was the development of future interventions to optimize outcomes.
