Brain Protein in Cord Blood Could Spot Birth Damage Earlier
Researchers found that measuring a brain protein (neurofilament light) in umbilical cord blood can identify newborns at risk of oxygen deprivation injury better than standard tests. The finding could enable hospitals to flag at-risk infants immediately after birth and intervene faster, potentially reducing long-term neurological damage and costly NICU stays.
Originaltitel: The association of umbilical cord blood neurofilament light with non-reassuring fetal status: A prospective observational study
Objective Early detection of hypoxic-ischemic encephalopathy (HIE) in neonates is critical. We conducted a pilot cohort study to determine the feasibility of collecting umbilical cord blood samples for neurofilament light (NfL) and to assess the association of NfL with non-reassuring fetal status and other cord biomarkers. We aimed to address (1) Feasibility of cord NfL sample collection and analysis; (2) Association of NfL with non-reassuring fetal status (CTG changes and/or documented non-reassuring fetal status), neonatal intensive care unit (NICU) admission and length of stay; (3) Correlation of NfL with other cord biomarkers.Methods This was a prospective cohort study performed in a single, large tertiary and quaternary referral hospital. A total of 108 maternal participants consented to donate cord blood. Umbilical cord blood NfL levels were measured via single molecule array (Simoa) analysis.Results Cord NfL was higher in preterm neonates and was correlated with cord lactate, pH, and base excess. After controlling for mode of delivery and gestational age, NfL (odds ratio [OR] = 2.29, 95% confidence interval [CI]: 1.15-5.57), but not pH (OR = 0.78, 95% CI: 0.42-1.41), base excess (OR = 0.83, 95% CI: 0.37-1.86), or lactate (OR = 1.06, 95% CI: 0.51-2.12) was associated with non-reassuring fetal status. NfL levels were higher in neonates admitted to NICU (median [IQR]: 11.3 [7] vs 8.5 [5.1]).Conclusion Cord blood NfL analysis was feasible and provided correlates of adverse outcomes. Higher venous cord blood NfL levels were associated with non-reassuring fetal status. Further research is needed to validate these findings and establish the role of NfL, if any, in clinical practice.