Cerebral Palsy, Infant, Low Birth Weight, Infant, Newborn, Infant, Premature, Infant, Small for Gestational Age
Conditions
Keywords
NICHD Neonatal Research Network, Very Low Birth Weight (VLBW), Extremely Low Birth Weight (ELBW), Prematurity, Pro-inflammatory cytokines, Anti-inflammatory cytokines, Interleukin-1 (IL-1β), Interleukin-2 (IL-2), Interleukin-3 (IL-3), Interleukin-8 (IL-8), Interleukin-9 (IL-9), Tumor necrosis factor-α (TNF-α), Regulated upon Activation, Normal T-cell Expressed and Secreted (RANTES)
Brief summary
This observational study assessed whether measurements of certain pro-inflammatory and anti-inflammatory cytokines in the blood (either singly or in combination) at birth and/or up to day of life 21 can predict cerebral palsy at 18-22 months corrected age.
Detailed description
Inflammatory cytokines \[interleukin-1 (IL-1β), IL-8, IL-9, tumor necrosis factor-α (TNF-α), and RANTES\] but not anti-inflammatory cytokines released during the perinatal period have been associated with the development of periventricular leukomalacia (PVL) and cerebral palsy (CP) in near term and term infants. However, because blood samples were obtained on any day between day 1 and 18, these data cannot distinguish between prenatal and postnatal effects on neurological outcome. Furthermore, very low birth weight infants who are at the highest risk have not been studies. The goal of this study was to measure pro-inflammatory and anti-inflammatory cytokine levels at various times in the perinatal period (at birth up to day of life 21), since they may be elevated at different points in the disease process. Blood samples (whole blood spots, dried on filter paper) were obtained on day 1 within 4 hours after birth, and on days 3, 7, 14, and 21. Neurodevelopmental assessments were conducted at 18-22 months corrected age.
Interventions
None listed
Sponsors
Centers for Disease Control and Prevention
National Center for Research Resources (NCRR)
NICHD Neonatal Research Network
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
No minimum to 72 Hours
Healthy volunteers
Yes
Inclusion criteria
* Infants 401-1,000 grams at birth
Exclusion criteria
* \>72 hours of age
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Pro-cytokines increased and anti-inflammatory cytokines decreased | At birth and/or up to Day 3±1 |
Secondary
| Measure | Time frame |
|---|---|
| Type and severity of CP and other neurodevelopmental handicaps, the appearance of PVL, and neonatal mortality | 18-22 months corrected age |
| Abnormal pro-inflammatory and anti-inflammatory cytokines at birth are associated with prenatal insults (e.g., chorioamnionitis, occult intrauterine infection, early-onset neonatal sepsis, perinatal asphyxia, early death) | At birth |
| Abnormal postnatal cytokine levels associated with postnatal insults (e.g., postnatal intraventricular hemorrhage, late-onset neonatal sepsis, bronchopulmonary dysplasia, chronic lung disease, and/or necrotizing enterocolitis) | Up to Day of life 21 |
| Pro-inflammatory cytokine elevations at the time of a workup for possible sepsis occur in infants with a positive bacterial blood culture and those with negative blood cultures who are treated with a full course of antibiotics | Up to Day of life 21 |
Countries
United States
Outcome results
None listed