Study of Cord blood Erythropoietin, leptin and adiponectin levels in neonates with Hypoxic Ischemic Encephalopathy.
BACKGROUND Hypoxic ischemic encephalopathy (HIE) is a serious condition which results in neonatal morbidity and mortality. Early prediction of HIE especially in first six hours of birth leads to early treatment with better prognosis. AIM OF THE WORK The aim of this study was to measure the levels of cord leptin, adiponectin and erythropoietin (EPO) in neonates with HIE. PATIENTS AND METHODS This study was carried out on 50 appropriate for gestational age (AGA) neonates with HIE born in Tanta University Hospital during the period from June 2016 to March 2018 (Group I) This study included also 50 appropriate for gestational age (AGA) normal neonates not suffering from any complications and matched with age and sex as a control group (Group II) For all neonates in both groups the following were done: Complete prenatal, natal and postnatal history, assessment of APGAR score at 5 and 10 minutes, complete clinical examination with especial account on clinical evidence of encephalopathy including hypotonia, abnormal oculomotor or pupillary movements, weak or absent suckling, apnea, hyperpnea, or seizures, measurement of cord blood gases and measurement of serum erythropoietin, leptin and adiponectin levels by ELISA immediately after birth. RESULTS There were no significant differences between Group I and Group II as regard gestational age, male to female ratio, mode of delivery and weight while there were significant differences as regard Apgar score at 1 and 5 minutes with significantly lower Apgar score at 1 and 5 minutes in group I compared with Group II. There were significantly lower cord blood adiponectin and PH and significantly higher cord blood Leptin and erythropoietin levels in group I compared with group II. There were significant differences between cord blood adiponectin, leptin, erythropoietin and PH in different degrees of HIE with significantly lower cord blood adiponectin and PH and significantly higher cord blood leptin and erythropoietin in severe degree of hypoxia compared with moderate and in moderate degree compared with mild degree of hypoxia.There was significant positive correlation between cord blood erythropoietin and leptin and significant negative correlation between cord blood erythropoietin and adiponectin and between cord blood erythropoietin and PH in studied neonates with hypoxia. There was significant positive correlation between cord blood adiponectin and cord blood PH and significant negative correlation between cord blood leptin and adiponectin and between cord blood leptin and PH in studied neonates with hypoxia. ROC curve showed that EPO had the best sensitivity and specificity followed by leptin then adiponectin while the PH had the least sensitivity and specificity as early predictors of hypoxic neonates. CONCLUSION AND RECOMMENDATIONS The significant differences between cord blood erythropoietin, leptin and adiponectin between neonates with hypoxia compared with normal neonates with significantly lower cord blood adiponectin and PH and significantly higher cord blood Leptin and erythropoietin levels in group I compared with group II may arouse our attention about the use of these markers in the cord blood as early predictors of neonatal HIE which can lead early treatment and subsequently better prognosis.
Endocrine, metabolic immune disorders drug targets