Boskabadi Hassan, Zakerihamidi Maryam, Ghayour Mobarhan Majid, Bagheri Fatemeh, Moradi Ali, Beiraghi Toosi Mehran
Department of Pediatrics, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran.
Department of Midwifery, School of Medicine, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran.
Iran J Child Neurol. 2023 Winter;17(1):99-110. doi: 10.22037/ijcn.v17i2.38561. Epub 2023 Jan 1.
Precise and early diagnosis of neonatal asphyxia may improve outcomes. Recent studies aim to identify diagnostic biomarkers in neonates at risk for brain damage. The current study was designed to evaluate the diagnostic value of new biomarkers for neonatal asphyxia.
MATERIALS & METHODS: This prospective study was conducted with an available sampling of infants upper 35 weeks of gestational age, including neonates with asphyxia (case group) and healthy controls, 2014-2022, in Ghaem Hospital, Mashhad, Iran. Data collection was performed utilizing a researcher-made questionnaire, including maternal and neonatal characteristics, as well as clinical and laboratory evaluation. Serum umbilical cord levels of interleukin-6 (IL6), interleukin-1-beta (IL- 1β), pro-oxidant-antioxidant balance (PAB), and heat shock protein-70 (HSP70), as well as nucleated red blood cells count (NRBC), were determined. Data were analyzed by t-test, Chi-square, receiver operating characteristic (ROC), and regression models.
The differences in variables IL6, IL1β, PAB, NRBC/100WBC, and HSP70 were statistically significant between the two groups (in all cases, P<0.0001). In the diagnosis of asphyxia, the most sensitive marker (89%) was IL1β more than 2.39 pg/ml and HSP 70 upper than 0.23 ng/ml, while IL6 was higher than 9pg/ml, determined as the most specific marker (85%). Furthermore, a combination of HSP + PAB and IL6 + lL1b + PAB + NRBC/100WBC possesses the prediction power of 93.2% and 87.3%, respectively, for diagnosing asphyxia.
According to data analysis, the combination of new biochemical markers (NRBC count, IL6, IL1β, PAB, and HSP 70) could be a reliable marker for diagnosing infants with asphyxia.
新生儿窒息的准确早期诊断可能改善预后。近期研究旨在识别有脑损伤风险的新生儿的诊断生物标志物。本研究旨在评估新生儿窒息新生物标志物的诊断价值。
本前瞻性研究于2014年至2022年在伊朗马什哈德的加姆医院对孕周超过35周的婴儿进行了抽样，包括窒息新生儿（病例组）和健康对照。数据收集使用了研究者自制的问卷，包括母亲和新生儿特征以及临床和实验室评估。测定了脐带血清中白细胞介素-6（IL6）、白细胞介素-1β（IL-1β）、促氧化剂-抗氧化剂平衡（PAB）、热休克蛋白-70（HSP70）水平以及有核红细胞计数（NRBC）。数据通过t检验、卡方检验、受试者工作特征曲线（ROC）和回归模型进行分析。
两组之间IL6、IL1β、PAB、NRBC/100WBC和HSP70变量的差异具有统计学意义（在所有情况下，P<0.0001）。在窒息诊断中，最敏感的标志物（89%）是IL1β超过2.39 pg/ml和HSP 70高于0.23 ng/ml，而IL6高于9pg/ml被确定为最特异的标志物（85%）。此外，HSP + PAB组合以及IL6 + IL1b + PAB + NRBC/100WBC组合对窒息诊断的预测能力分别为93.2%和87.3%。
根据数据分析，新的生化标志物（NRBC计数、IL6、IL1β、PAB和HSP 70）组合可能是诊断窒息婴儿的可靠标志物。
