Peer-Reviewed Journal Details
Mandatory Fields
O'Boyle, DS;Dunn, WB;O'Neill, D;Kirwan, JA;Broadhurst, DI;Hallberg, B;Boylan, GB;Murray, DM
2021
February
Journal of Pediatrics
Improvement in the Prediction of Neonatal Hypoxic-Ischemic Encephalopathy with the Integration of Umbilical Cord Metabolites and Current Clinical Makers
Validated
WOS: 5 ()
Optional Fields
THERAPEUTIC HYPOTHERMIA METABOLOMIC PROFILE KYNURENINE PATHWAY PERINATAL ASPHYXIA NEWBORNS OUTCOMES LACTATE
229
175
Objective To validate our previously identified candidate metabolites, and to assess the ability of these metabolites to predict hypoxic-ischemic encephalopathy (HIE) both individually and combined with clinical data.Study design Term neonates with signs of perinatal asphyxia, with and without HIE, and matched controls were recruited prospectively at birth from 2 large maternity units. Umbilical cord blood was collected for later batch metabolomic analysis by mass spectroscopy along with clinical details. The optimum selection of clinical and metabolites features with the ability to predict the development of HIE was determined using logistic regression modelling and machine learning techniques. Outcome of HIE was determined by clinical Sarnat grading and confirmed by electroencephalogram grade at 24 hours.Results Fifteen of 27 candidate metabolites showed significant alteration in infants with perinatal asphyxia or HIE when compared with matched controls. Metabolomic data predicted the development of HIE with an area under the curve of 0.67 (95% CI, 0.62-0.71). Lactic acid and alanine were the primary metabolite predictors for the development of HIE, and when combined with clinical data, gave an area under the curve of 0.96 (95% CI, 0.92-0.95).Conclusions By combining clinical and metabolic data, accurate identification of infants who will develop HIE is possible shortly after birth, allowing early initiation of therapeutic hypothermia.
NEW YORK
0022-3476
10.1016/j.jpeds.2020.09.065
Grant Details