PROGNOSTIC VALUE OF NEURON SPECIFIC ENOLASE IN SERUM FOR OUTCOME OF INFANTS WITH BIRTH ASPHYXIA

Abstract

Background: Birth asphyxia [BA] and the resultant hypoxic ischemic encephalopathy [HIE] is a common cause of neonatal morbidity and mortality and neurologic disabilities among survivors .It is important to find an early and reliable indicator of brain damage and of poor long-term prognosis to initiate or end neuroprotective treatment.
Objective: Assess if neuron specific enolase [NSE] can be used as a serum biochemical marker of brain damage in neonates exposed to perinatal asphyxia [PA], and if it can be used in predicting long- term outcome in these infants.
Study design: This prospective study was carried out on 50 neonates who were delivered in the Obstetric Department of Zagazig University Hospitals and admitted to the neonatal intensive care unit [NICU]. The patient group comprised 30 full term neonates who developed symptoms and signs of HIE. Twenty healthy full term neonates of matched age, sex and weight served as a control group. All neonates were subjected to; history-taking, clinical examination and laboratory investigations, including measurement of serum NSE by enzyme immuometric assay. In addition survivor neonates were subjected to follow-up at 6 month and 12 month.
Results: Apgar scores and arterial cord blood pH were significantly lower in HIE neonates than that in control neonates. Meanwhile, serum NSE and arterial cord blood base deficit were significantly higher in HIE neonates than that in control neonates. Serum NSE was significantly higher in neonates suffering HIE grade II & grade III than that in HIE grade I& control neonates. Furthermore, serum NSE was very highly significantly increased in neonates who had neurological sequalae than that in control neonates.
Conclusion and recommendation: Serum NSE correlated significantly with HIE grades II&III and neonates who suffered neurological sequalae. So it may be used as a marker of grades II& III and neurological sequalae in asphyxiated neonates. However, it can not be used to prevent BA.