|Title||Neonatal Biomarkers of Inflammation: Correlates of Early Neurodevelopment and Gait in Very-Low-Birth-Weight Preterm Children.|
|Publication Type||Journal Article|
|Year of Publication||2016|
|Authors||Rose J, Vassar R, Cahill-Rowley K, Hintz SR, Stevenson DK|
|Journal||Am J Perinatol|
|Date Published||2016 Jan|
|Keywords||Biomarkers, Birth Weight, Bronchopulmonary Dysplasia, C-Reactive Protein, Child Development, Cognition, Enterocolitis, Necrotizing, Female, Gait, Gestational Age, Humans, Infant, Infant, Newborn, Infant, Premature, Infant, Very Low Birth Weight, Inflammation, Intensive Care Units, Neonatal, Linear Models, Male, Motor Activity, Multivariate Analysis, Psychiatric Status Rating Scales, Risk Factors, Sepsis, Speech|
OBJECTIVE: Neonatal biomarkers of inflammation were examined in relation to early neurodevelopment and gait in very-low-birth-weight (VLBW) preterm children. We hypothesized that preterm infants exposed to higher levels of neonatal inflammation would demonstrate lower scores on Bayley Scales of Infant Toddler Development, 3rd ed. (BSID-III) and slower gait velocity at 18 to 22 months adjusted age.
STUDY DESIGN: A total of 102 VLBW preterm infants (birthweight [BW] ≤ 1,500 g, gestational age [GA] ≤ 32 weeks) admitted to neonatal intensive care unit [NICU] were recruited. Neonatal risk factors examined were GA at birth, BW, bronchopulmonary dysplasia, necrotizing enterocolitis, retinopathy of prematurity, sepsis, and serum C-reactive protein (CRP), albumin, and total bilirubin over first 2 postnatal weeks. At 18 to 22 months, neurodevelopment was assessed with BSID-III and gait was assessed with an instrumented mat.
RESULTS: Children with neonatal CRP ≥ 0.20 mg/dL (n = 52) versus < 0.20 mg/dL (n = 37) had significantly lower BSID-III composite cognitive (92.0 ± 13.1 vs. 100.1 ± 9.6, p = 0.002), language (83.9 ± 16.0 vs. 95.8 ± 14.2, p < 0.001), and motor scores (90.0 ± 13.2 vs. 98.8 ± 10.1, p = 0.002), and slower gait velocity (84.9 ± 19.0 vs. 98.0 ± 22.4 cm/s, p = 0.004). Higher neonatal CRP correlated with lower cognitive (rho = - 0.327, p = 0.002), language (rho = - 0.285, p = 0.007), and motor scores (rho = - 0.257, p = 0.015), and slower gait (rho = - 0.298, p = 0.008). Multivariate analysis demonstrated neonatal CRP ≥ 0.20 mg/dL significantly predicted BSID-III cognitive (adjusted R(2) = 0.104, p = 0.008), language (adjusted R(2) = 0.124, p = 0.001), and motor scores (adjusted R(2) = 0.122, p = 0.004).
CONCLUSIONS: Associations between low-level neonatal inflammation and neurodevelopment suggest early biomarkers that may inform neuroprotective treatment for preterm children.
|Alternate Journal||Am J Perinatol|
|Grant List||UL1 RR025744 / RR / NCRR NIH HHS / United States|