Boutalbi Narjess, Dahan Samuel, Rozalen William, Beretti Thibault, Fortis Laurene, Delefosse Lucie, Cloarec Robin, Testud Benoit, Fouilloux Virginie, Gran Célia, Danielou Giulia, Paoli Florent, El-Louali Fedoua, Blanc Julie, Velly Camille, Carles Guillaume, Wanert Chloe, Quennelle Sophie, Lebel Stéphane, Denantes Solène, Bourgoin Pierre, Laborier Matthieu, Arnaud Sophie, Santelli Dominique, Aries Edouard, Allary Chloé, Grandvuillemin Isabelle, Desrobert Clotilde, Calderon Johanna, Boubred Farid, Michel Fabrice, Ovaert Caroline, Milh Mathieu, Lenoir Marien, Desnous Béatrice
Pediatric Neurology Department, Timone Enfant, APHM, Marseille, France.
Pediatric Anesthesia and Intensive Care Unit, APHM La Timone, Marseille, France.
Pediatr Res. 2025 Sep 24. doi: 10.1038/s41390-025-04437-8.
Children with complex congenital heart disease (CCHD) are at high risk for early neurodevelopmental delays across all domains. Neuromotor delay often emerges first and may impact broader development. Identifying early biomarkers of motor function could capture a critical window for intervention. We assessed the prognostic value of neuron-specific enolase (NSE) and S100B in predicting 4-month motor outcomes in newborns undergoing cardiac surgery with cardiopulmonary bypass (CPB).
Between December 2021 and October 2024, we conducted a prospective, single-centre study including term neonates with (CCHD) who required cardiac surgery within the first two months of life. NSE and S100B levels were measured at five perioperative time points. Blinded Alberta Infant Motor Scale (AIMS) assessment at four months evaluated motor outcomes.
Of 35 newborns, 27 completed follow-up. Preoperative NSE levels were significantly higher in infants with AIMS scores below the 10th percentile (32.7 vs. 20.9 ng/mL, p = 0.044) and negatively correlated with AIMS percentiles (ρ = -0.617, p = 0.006. There was no significant association between motor outcomes, MRI findings or S100B levels.
Higher preoperative NSE levels predict poor early motor outcomes in CCHD and may be a marker for early risk stratification and intervention.
Neuron-specific enolase (NSE) may serve as an early biomarker of neuromotor development in newborns with complex congenital heart disease (CCHD). Elevated preoperative NSE levels were associated with poorer motor outcomes at four months. NSE may serve as an additional biomarker within a multimodal risk stratification strategy, complementing clinical, imaging, and electrophysiological assessments to refine prognostic evaluation. These findings highlight the prognostic value of perioperative biomarkers for predicting early motor outcomes and support earlier identification of at-risk newborns, enabling targeted neurodevelopmental interventions. This work adds new evidence to limited literature on biological predictors of motor development after neonatal cardiac surgery.
