Jessica Rose1, Rachel Vassar1, Katelyn Cahill-Rowley1, Susan R Hintz2, David K Stevenson2. 1. Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California. 2. Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, California.
Abstract
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. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
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. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Melissa K Thoene; Matthew C Van Ormer; Elizabeth R Lyden; Maranda K Thompson; Ana G Yuil-Valdes; Sathish Kumar Natarajan; Maheswari S Mukherjee; Tara M Nordgren; Jeremy D Furtado; Ann L Anderson-Berry; Corrine K Hanson; Jessica N Snowden Journal: Pediatr Res Date: 2020-12-08 Impact factor: 3.756
Authors: Marliese Dion Nist; Abigail B Shoben; Tondi M Harrison; Deborah K Steward; Rita H Pickler Journal: West J Nurs Res Date: 2021-09-07 Impact factor: 1.967
Authors: Alan Leviton; Elizabeth N Allred; Raina N Fichorova; Karl C K Kuban; T Michael O'Shea; Olaf Dammann Journal: Early Hum Dev Date: 2015-12-28 Impact factor: 2.079
Authors: Alexis E Cullen; Ben M Tappin; Patricia A Zunszain; Hannah Dickson; Ruth E Roberts; Naghmeh Nikkheslat; Mizan Khondoker; Carmine M Pariante; Helen L Fisher; Kristin R Laurens Journal: Brain Behav Immun Date: 2017-07-08 Impact factor: 7.217
Authors: Katherine A Bell; Lillian G Matthews; Sara Cherkerzian; Caroline Palmer; Kaitlin Drouin; Hunter L Pepin; Deirdre Ellard; Terrie E Inder; Sara E Ramel; Mandy B Belfort Journal: J Pediatr Date: 2019-07-31 Impact factor: 6.314