AI Article Synopsis
- This study explores how neurofilament light chain (NfL), a marker for brain injury, relates to neurovascular issues in extremely preterm infants, specifically those born before 28 weeks gestational age.
- Researchers found that higher NfL levels in the first month after birth are associated with severe intraventricular hemorrhage (IVH) and retinopathy of prematurity (ROP), especially in infants born before 25 weeks gestational age.
- The results suggest that NfL could be a potential predictor of neonatal morbidities linked to a more porous blood-brain barrier, indicating the need for further research in this area.
Article Abstract
Background: Neurofilament light chain (NfL) is known for indicating adult brain injury, but the role of NfL in extremely preterm infants is less studied. This study examines the relationship between NfL and neurovascular morbidities in these infants.
Methods: A secondary analysis of the Mega Donna Mega trial was conducted on preterm infants <28 weeks gestational age (GA). The study measured NfL levels and proteomic profiles related to the blood-brain barrier in serum from birth to term-equivalent age, investigating the association of NfL with GA, retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), and blood-brain barrier proteins.
Results: Higher NfL levels were seen in the first month in infants with severe IVH and for those born <25 weeks GA (independent of ROP or IVH). Additionally, infants born at 25-27 weeks GA with high NfL were at increased risk of developing severe ROP (independent of IVH). NfL was significantly associated with the proteins CDH5, ITGB1, and JAM-A during the first month.
Conclusion: NfL surges after birth in extremely preterm infants, particularly in those with severe IVH and ROP, and in the most immature infants regardless of IVH or ROP severity. These findings suggest NfL as a potential predictor of neonatal morbidities, warranting further validation studies.
Impact Statement: This study shows that higher NfL levels are related to neurovascular morbidities in extremely preterm infants. The degree of immaturity seems important as infants born <25 weeks gestational age exhibited high postnatal serum NfL levels irrespective of neurovascular morbidities. Our findings suggest a potential link between NfL and neurovascular morbidities possibly affected by a more permeable blood-brain barrier.
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| http://dx.doi.org/10.1038/s41390-024-03587-5 | DOI Listing |
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