Title: Neonatal Biomarkers of Inflammation: Correlates of Early Neurodevelopment and Gait in Very-Low-Birth-Weight Preterm Children
Abstract: <b>Objective</b> 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. <b>Study Design</b> 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. <b>Results</b> Children with neonatal CRP ≥ 0.20 mg/dL (<i>n</i> = 52) versus < 0.20 mg/dL (<i>n</i> = 37) had significantly lower BSID-III composite cognitive (92.0 ± 13.1 vs. 100.1 ± 9.6, <i>p</i> = 0.002), language (83.9 ± 16.0 vs. 95.8 ± 14.2, <i>p</i> < 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, <i>p</i> = 0.004). Higher neonatal CRP correlated with lower cognitive (rho = − 0.327, <i>p</i> = 0.002), language (rho = − 0.285, <i>p</i> = 0.007), and motor scores (rho = − 0.257, <i>p</i> = 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<sup>2</sup> = 0.104, <i>p</i> = 0.008), language (adjusted R<sup>2</sup> = 0.124, <i>p</i> = 0.001), and motor scores (adjusted R<sup>2</sup> = 0.122, p = 0.004). <b>Conclusions</b> Associations between low-level neonatal inflammation and neurodevelopment suggest early biomarkers that may inform neuroprotective treatment for preterm children.
Publication Year: 2015
Publication Date: 2015-07-24
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 26
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