Association Between Tau Proteins Levels And Neonatal Brain Injury: A Meta-analysis

Objective:To systematically review the association between Tau Proteins levels and neonatal brain injury,so as to provide evidence-based basis for early diagnosis of neonatal brain injury.Methods:PubMed,The Cochrane Library,Web of Science,Embase,CBM,CNKI,Wanfang and VIP databases were searched to collect published studies on the association between Tau Proteins levels and neonatal brain injury from inception to February,2021.Two researchers independently screened literature,extracted data and evaluated risk of bias.Meta-analysis was performed using Review Manager 5.3 software.Egger and Begg test were used to evaluate the publication bias of the included studies.Results:A total of 19 case-control studies were included.All the samples were from serum,and samples were collected within 24 hours,1-3 days and7-10 days after birth.According to the severity of brain injury,some cases were divided into mild,moderate and severe groups.The results of meta-analysis showed that the serum Tau Proteins levels in case group were higher than control group no matter the collection time was within 24 hours,1-3 days or 7-10 days after birth(SMD_{within 24h}=2.37,95%CI 1.64 to 3.10,P<0.00001;SMD_1³d=1.53,95%CI 1.03 to 2.04,P<0.00001;SMD_7¹0d=1.30,95%CI 0.92 to 1.68,P<0.00001).And serum Tau Proteins levels gradually increased with the aggravation of neonatal brain injury.Analysis results within24 hours after birth(SMD_{moderate vs mild}=1.48,95%CI 1.26 to 1.71,P<0.00001;SMD_{severe vs mild}=1.94,95%CI 1.71 to 2.17,P<0.00001;SMD_{severe vs moderate}=1.20,95%CI 0.65 to 1.75,P<0.0001).Analysis results of 1-3 days after birth(SMD_{moderate vs mild}=1.03,95%CI 0.56 to 1.51,P<0.0001;SMD_{severe vs mild}=2.14,95%CI 1.83 to 2.45,P<0.00001;SMD_{severe vs moderate}=1.14,95%CI0.55 to 1.74,P=0.0002).Analysis results of 7-10 days after birth(SMD_{moderate vs mild}=1.58,95%CI 1.03 to 2.14,P<0.00001;SMD_{severe vs mild}=2.76,95%CI 1.99to 3.52,P<0.00001;SMD_{severe vs moderate}=1.47,95%CI 0.96 to 1.98,P<0.00001).There was no significant difference between two groups of specimens collected within 24 hours and 1-3 days after birth（SMD=0.29,95%CI-0.27 to0.85,P=0.30）.However,the serum Tau Proteins levels in the two groups were higher than those in the 7-10 day group（SMD=0.74,95%CI 0.15 to 1.33,P=0.01;SMD=0.77,95%CI 0.21 to 1.32,P=0.007）.Conclusions:1.The levels of serum Tau Proteins is correlated with neonatal brain injury,and it is suggested that the serum Tau Proteins should be detected as soon as possible in neonates with high risk factors of brain injury,so as to provide basis for early diagnosis of the disease.2.With the aggravation of neonatal brain injury,the serum Tau Proteins levels increased gradually,indicating that the levels can be used to evaluate the severity of neonatal brain injury.3.With the recovery of neonatal brain injury,the serum Tau Proteins decreased gradually,suggesting that dynamic monitoring of serum Tau Proteins levels is helpful to judge the recovery of brain injury.