Pediatrics international : official journal of the Japan Pediatric Society · 2026
Neurological Assessment Tools and Inflammatory Biomarkers for Predicting Cerebral Palsy in Neonatal HIE.
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Yılmaz Celil, İşleyen Fatih, Koyuncu İsmail, Kipoğlu Osman
Аннотация
BACKGROUND: To evaluate temporal changes in serum interleukin-40 (IL-40), hypoxia-inducible factor-1 alpha (HIF-1α), and procalcitonin (PCT) levels between early and post-rewarming measurements in neonates with moderate-to-severe hypoxic-ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH), and to determine the prognostic value of these biomarkers together with the Hammersmith Neonatal Neurological Examination (HNNE), amplitude-integrated electroencephalography (aEEG), and magnetic resonance imaging (MRI) for predicting cerebral palsy (CP).
METHODS: Thirty-five neonates with HIE treated with TH and 20 healthy term neonates were prospectively enrolled. Serum IL-40, HIF-1α, and PCT levels were measured before and after TH. Associations between biomarkers, HNNE, aEEG, MRI findings, and CP at follow-up were evaluated.
RESULTS: Serum IL-40, HIF-1α, and PCT levels decreased significantly between the early and post-rewarming measurements (all p < 0.001). Although biomarker levels differed from controls, they were not associated with subsequent CP. In contrast, HNNE, aEEG, and MRI showed strong prognostic performance for subsequent CP among surviving infants.
CONCLUSION: Serum IL-40, HIF-1α, and PCT levels showed significant temporal decreases between the early and post-rewarming measurements in neonates with HIE undergoing TH; however, these biomarkers did not predict subsequent CP among surviving infants. HNNE, aEEG, and MRI each demonstrated strong prognostic performance for subsequent CP when evaluated individually in this cohort.
METHODS: Thirty-five neonates with HIE treated with TH and 20 healthy term neonates were prospectively enrolled. Serum IL-40, HIF-1α, and PCT levels were measured before and after TH. Associations between biomarkers, HNNE, aEEG, MRI findings, and CP at follow-up were evaluated.
RESULTS: Serum IL-40, HIF-1α, and PCT levels decreased significantly between the early and post-rewarming measurements (all p < 0.001). Although biomarker levels differed from controls, they were not associated with subsequent CP. In contrast, HNNE, aEEG, and MRI showed strong prognostic performance for subsequent CP among surviving infants.
CONCLUSION: Serum IL-40, HIF-1α, and PCT levels showed significant temporal decreases between the early and post-rewarming measurements in neonates with HIE undergoing TH; however, these biomarkers did not predict subsequent CP among surviving infants. HNNE, aEEG, and MRI each demonstrated strong prognostic performance for subsequent CP when evaluated individually in this cohort.