Abstract
medRxiv [Preprint]. 2025 Jan 25:2025.01.23.25320706. doi: 10.1101/2025.01.23.25320706.
ABSTRACT
OBJECTIVE: Early detection of hypoxic-ischaemic encephalopathy (HIE) in neonates is critical. We conducted a pilot cohort study to determine the feasibility of collecting umbilical cord blood samples for neurofilament light (NfL) and to assess the association of NfL with non-reassuring fetal status and other cord biomarkers.
DESIGN: Prospective cohort study.
SETTING: A single, large tertiary and quaternary referral hospital.
PATIENTS: 108 maternal participants consenting to donate cord blood.
INTERVENTION: Umbilical cord venous blood plasma NfL levels.
MAIN OUTCOME MEASURES: (1) Feasibility of cord NfL sample collection and analysis; (2) Association of NfL with non-reassuring fetal status (CTG changes and/or documented non-reassuring fetal status), NICU admission and length of stay; (3) Correlation of NfL with other cord biomarkers.
RESULTS: Cord NfL was higher in preterm neonates, and was correlated with cord lactate, pH, and base excess. After controlling for mode of delivery and gestational age, NfL (OR = 2.29, 95%CI: 1.15 to 5.57), but not pH (OR = 0.78, 95%CI: 0.42 to 1.41), base excess (OR = 0.83, 95%CI: 0.37 to 1.86), or lactate (OR = 1.06, 95%CI: 0.51 to 2.12) was associated with non-reassuring fetal status. NfL levels were higher in neonates admitted to NICU (median (IQR): 11.3 (7) versus 8.5 (5.1)).
CONCLUSIONS: Cord blood NfL analysis was feasible and provided correlates of adverse outcomes. Higher venous cord blood NfL levels were associated with non-reassuring fetal status. Further research is needed to validate these findings and establish the role of NfL, if any, in clinical practice.
PMID:39974024 | PMC:PMC11838990 | DOI:10.1101/2025.01.23.25320706
UK DRI Authors
