Early markers of brain damage in premature low-birth-weight neonates who suffered from perinatal asphyxia and/or infection

We studied 57 low-birth-weight premature neonates, of whom 29 suffered from perinatal asphyxia and/or infection, while the remaining 28 did not and se rved as controls. We measured peripheral nucleated red blood cell (NRBC) ab solute numbers as well as interleukin (IL)-1 beta, IL-6 and tumour necrosis factor (TNF)-alpha cytokine serum levels at 24 h postnatally and on days 3 and 7 following birth. Fourteen of the asphyxiated/infected neonates and 1 2 controls had neurologic assessments at the corrected postnatal age of 18 months. We found NRBC absolute numbers and serum IL-1 beta and IL-6 cytokin e levels at 24 h postnatally to be significantly higher in neonates with pe rinatal asphyxia/infection than in the controls (p = 0.022, p = 0.036 and p = 0.037, respectively), TNF-alpha levels did not differ. Neurologic examin ation at the corrected postnatal age of 18 months showed 8 out of the 14 ch ildren who had been asphyxiated/ infected as neonates to have abnormal find ings, while 12 children who were used as controls during their neonatal per iod were normal. Abnormal neurologic findings correlated with high NRBC cou nts and IL-1 beta and IL-6 levels at 24 h postnatally. In conclusion, incre ased NRBC counts and proinflammatory cytokine levels in asphyxiated/infecte d neonates represent early markers for subsequent neurologic impairment. Co pyright (C) 2001 S. Karger AG. Basel.