Abstract
Objective To investigate the diagnostic and prognostic value of neuromediators (brain derivated neurotrophic factor-BDNF, galanin and neuropeptide Y-NPY) in pretem and term neonates with neonatal encephalopathy. Methods Fifty three neonates (preterm: 26, term: 27) who had lumbar puncture for the diagnostic investigation of neonatal encephalopathy in Ege University Children's Hospital NICU were enrolled to the study. Study group were divided in to 4 groups according to their gestational ages and based on whether they had seizures or not: Group 1: preterm neonates with seizures (n=13), Group 2: preterm neonates without seizures (n=13), Group 3: term neonates with seizures (n=13), Group 4: term neonates without seizures (n=14). Control group consisted of 32 healthy newborns (preterm: 13, term: 19) who were delivered in the same time frame at Ege University Hospital Maternity Ward. Only cord blood samples were obtained from these neonates. Amplitude integrated EEG (aEEG) and conventional EEG (cEEG) were simulataneously performed for neonates in NICU. All infants Infants were followed up prospectively and were evaluated with GMCD (Guide for Monitoring Child Development) and ADSI (Ankara Developmental Screening Inventory). Overal outcome at one-year-old was divided into two groups (favorable and unfavorable). Results There were no significant relationship between serum and CSF levels of BDNF, NPY, and galanin with gestational age. Serum BDNF, NPY, and galanin levels were suppressed in the neonates with neonatal encephalopathy in NICU compared to the healthy controls. Serum BDNF, serum NPY, CSF BDNF and CSF NPY levels were increased in neonates with clinical seizures. Conclusion Increased serum and CSF levels of BDNF and NPY in preterm and term neonates with clinical seizures might be indicators for early recognition of neonatal seizures. Supressed serum and CSF levels of neuromediators might be associated with unfavorable neurological outcome of neonates with neonatal encephalopathy in NICU.
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