Cord blood brain derived neurotrophic factor: Diagnostic and prognostic marker in fullterm newborns with perinatal asphyxia

Abstract

This prospective case control study was designed to evaluate cord blood brain derived neurotrophic factor level in full term newborns with perinatal asphyxia as a marker of central nervous system insult and predictor of severity of hypoxic ischemic encephalopathy, with follow up of its level during the reperfusion phase. The study included twenty fullterm neonates with perinatal asphyxia (cases) and twenty controls. Cord blood samples were obtained at birth and peripheral blood samples at 72 h postnatal from cases only. Plasma brain derived neurotrophic factor level was measured using enzyme linked immunosorbent assay. The clinical severity of encephalopathy was graded based on Sarnat and Sarnat staging. Cord Plasma brain derived neurotrophic factor level was significantly increased among cases compared to controls. Among cases, brain derived neurotrophic factor level at delivery and after 72 h significantly correlated with the severity of encephalopathy according to Sarnat staging being higher as severity increases. Brain derived neurotrophic factor level significantly increased after 72 h of life compared to its level at delivery among cases. Brain derived neurotrophic factor levels at delivery and at 72 h postnatal were predictors of severe Sarnat stage and poor outcome. We concluded that brain derived neurotrophic factor level as a marker of central nervous system insult is increased in full term newborns with perinatal asphyxia. It can serve as an indicator for the severity of encephalopathy and adverse outcomes.