The significance of the study of neuregulin-1 for predicting the development of cerebral leukomalacia in extremely premature infants

Introduction. It is known that cerebral palsy is often associated with intraventricular hemorrhages and cerebral leukomalacia suffered in the neonatal period in very premature infants. Neuregulin-1, which is involved in the processes of cerebral ischemia and systemic inflammation, may become one of the predictors of its formation.

Aim. The study was to study the concentration of neuregulin-1 in the blood of very premature infants in order to clarify the risk factors for the development of cerebral leukomalacia (P91.2) in them.

Materials and methods. A single-center cohort study was conducted. A total of 83 very premature infants were examined. The group with leukomalacia included 7 children, the group with perinatal neurological damage without signs of leukomalacia included 76 premature infants. Additionally, the content of neuregulin-1 in venous blood was determined on the 1st day of life.

Results. The concentration of neuregulin-1 in the blood of deeply premature newborns is statistically significantly lower in children from mothers with preeclampsia, gestational diabetes mellitus, colpitis, and polyhydramnios. The most significant risk factors for cerebral leukomalacia are the degree of respiratory failure (Silverman score ≥ 6 points; OR = 58.805, 95% СI 5,195–665,678; p < 0.001), severe asphyxia at birth (OR = 9,321, 95% CI 1.084–80.135; p < 0.042). The concentration of neuregulin – 1 in the blood of deeply premature newborns on day 1 of life is a predictor of the development of grade III cerebral ischemia and cerebral leukomalacia. A method has been developed for predicting cerebral leukomalacia by calculating the prognostic index D, taking into account the head circumference, the Apgar score, the Silverman score, and the level of neuroregulin-1 on the first day of life.

Conclusion. The predictor of cerebral leukomalacia in deeply premature infants is neuroregulin-1, a universal cytoprotector involved in the anti-inflammatory and antioxidant protection of neurons. A method has been proposed for predicting cerebral leukomalacia based on the level of neuroregulin-1 on the first day of life.

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