A study on the correlation of heat shock protein 70, NBNA score and neonatal asphyxia

Abstract

Objective To study the clinical value of heat shock protein (HSP)70 in the diagnosis of neonatal asphyxia and the correlation of HSP70 and Neonatal Behavioral Neurological Assessment (NBNA) score. Methods From January 2014 to June 2016, full-term neonates born in our hospital were enrolled in the study and assigned into mild and severe asphyxia groups. Normally delivered full-term infants were assigned to the control group. Blood from umbilical artery were extracted immediately after birth and HSP70 levels were detected using ELISA. The NBNA scores were recorded at the 7th, 14th and 28th-day after birth. Results HSP70 levels in both mild(n=46)and severe(n=35)asphyxia groups were significantly higher than the control group(n=50)[(14.4±2.7)ng/ml、(17.7±4.5)ng/ml than(11.9±2.3)ng/ml, P<0.05]. The severe asphyxia group had even higher HSP70 levels than the mild asphyxia group (P<0.05). The NBNA scores of both asphyxia groups were significantly lower than the control group (P<0.05). The umbilical pH values of both two asphyxia groups were also significantly lower than the control group(P<0.05). Correlation analysis showed that HSP70 level was negative correlated with NBNA score (7th, 14th, 28th-day) (r=-0.574、-0.493、-0.208, P<0.05). The HSP70 level was negatively correlated with umbilical pH (r=-0.576, P<0.05). The area under curve(AUC)for HSP70 levels to predict asphyxia was 0.798(95%CI 0.722~0.874, P<0.05). Conclusions HSP70 level in umbilical cord blood can be used as an indicator for neonatal asphyxia. The more severe the asphyxia, the higher the HSP70 levels and the lower NBNA score and umbilical pH. Key words: HSP70 heat-shock proteins; Asphyxia neonatorum; Neonatal behavioral neurological assessment