Biomarkers Associated With Neonatal Asphyxia

ObjectiveTo analyze the protein concentration in the peripheral blood of asphyxiated newborn,in order to find a simple method,and to detect and dynamic monitoring markers to warning of brain injuryMethodsA total of 36 neonates hospitalizing in the Kowloon Hospital from July 2018 to July 2019 and diagnosed with neonatal asphyxia are selected as the asphyxia group.According to Apgar score at birth,it was divided into severe asphyxia group(7 cases)and mild asphyxia group(29 cases).The 20 full-term newborns born in the hospital with no birth asphyxiation history of the same period are as the normal control group.The blood samples are collected at admission,3 days after birth,and 7 days after birth.The levels of S100B,S100A8,Apo-M and activin A in asphyxia group and control group are determined by enzyme-linked immunosorbent assay.All neonates in the asphyxia group undergo Cranial MRI(average time 2.68±1.01 days).Then,according to the presence or absence of abnormalities,the group is divided into MRI normal group and MRI abnormal group.Finally,a statistical analysis of the collected data is performed to compare the trends of the same biomarkers at different times and the differences between the different groups.Results1.There are 36 neonates in the asphyxia group,including 26 males and 10 females,with an average gestational age of 39.71±1.11 weeks and an average birth weight of 3.54±0.40 kg.There are 20 neonates in the control group,including 14 males and 6 females.the mean gestational age is 39.43±1.21 weeks,and the average birth weight is 3.45 ± 0.35 kg.Statistically,there is no significant difference in gestational age,gender,and birth weight between the two groups,P>0.052.The protein level of S100B in asphyxia group is significantly higher than that in the control group at each time point,P<0.01.There are significant differences in S100B protein level between severe asphyxia,mild asphyxia,and control group,F=30.82,P<0.01.In which,the level of severe asphyxia group is significantly higher than the mild asphyxia group on the 1st and 3rd day,P<0.05.While,it will decrease significantly on the 7th day,there will be no significant difference between the mild asphyxia group and the severe asphyxia group.Thus,the elevated S100B protein level may indicate acute craniocerebral injury.The protein level of MRI abnormal group is significantly higher than the MRI normal group at each time point,and the differences are statistically significant,F=37.97,P<0.001.3.The protein level of S100A8 in asphyxia group is significantly higher than that in the control group at each time point,P<0.01.There is significant difference in S100A8 protein level between severe asphyxia and mild asphyxia,F=3.28,P<0.05.In which,the protein level of severe asphyxia group is significantly higher than that of mild asphyxia group on the 1st and 7th day,P<0.01.While,the S100A8 protein level in the severe asphyxia group decreases on the 3rd day,there is no significant difference with the mild asphyxia group,P>0.05.The protein level of MRI abnormal group is significantly higher than that of MRI normal group and the control group at each time point,the difference is statistically significant,F=3.96,P<0.014.The apolipoprotein M protein level in the asphyxiation group is significantly lower than that in the control group at each time point,F=25.76,P<0.01.The protein level of severe asphyxia group is not significantly different from the mild asphyxia group on the 1st and 3rd day,P>0.016.Progressively decreased with time,the level significantly lower than the mild asphyxia group on the 7th day,the difference is statistically significant,P<0.001.There is no significant difference between MRI abnormal group and MRI normal group on the first day and the third day.On the seventh day,MRI abnormal group was lower than MRI normal group,with significant difference,P<0.001.5.There is no significant difference in activin A protein level among all groups at different time points after birthConclusion1.S100B and S100A8 is closely related to brain injury,and the protein levels of S100B and S100A8 continue to be high.It is suggested that monitoring the protein levels of S100B and S100A8 may indirectly reflect the brain injury of neonates2.The level of Apo-M protein in the asphyxia group is lower than that in the control group at three time points.The decrease of apo-M protein protein level may be related to hypoxic brain injury.