The following is a summary of “Correlation analysis between the amniotic fluid contamination and clinical grading of neonatal hypoxic-ischemic encephalopathy and biomarkers of brain damage,” published in the March 2024 issue of Pediatrics by Lv et al.

Amniotic fluid contamination (AFC) represents a recognized risk factor for neonatal hypoxic-ischemic encephalopathy (HIE), yet the precise correlation between AFC levels and both the incidence and clinical severity of HIE, alongside relevant biomarkers of brain damage, remains largely unexplored.

In this single-center observational study, 75 neonates diagnosed with moderate-to-severe HIE were categorized into four subgroups based on AFC levels: normal amniotic fluid with HIE group (NAF-HIE), I°AFC with HIE group (I°AFC-HIE), II°AFC with HIE group (II°AFC-HIE), and III°AFC with HIE group (III°AFC-HIE). An additional control group comprised 35 healthy neonates. Clinical grading of neonatal HIE followed the Sarnat and Sarnat criteria. Levels of serum tau protein and S100B were quantified using enzyme-linked immunosorbent assay kits, with correlations analyzed through Pearson correlation analysis.

The incidence of neonatal HIE was 26.7% in the NAF-HIE group, 17.3% in the I°AFC-HIE group, 13.3% in the II°AFC-HIE group, and 42.7% in the III°AFC-HIE group. Among 44 cases with severe HIE, 26 (59.1%) occurred in the III°AFC-HIE group, exhibiting a significantly higher incidence of severe HIE compared to moderate HIE (p < 0.05). Serum tau protein and S100B levels were significantly elevated in the HIE groups compared to the control group (all p < 0.05), with the III°AFC-HIE group showing significantly higher levels than the NAF-HIE and I°AFC-HIE groups (all p < 0.05). Levels of serum tau protein and S100B were significantly higher in the severe HIE group compared to the moderate HIE group (all p < 0.05). There was a significant positive correlation between serum tau protein and S100B levels (r = 0.7703, p < 0.0001).

In neonates with severe HIE, a higher incidence of III°AFC was observed alongside increased levels of serum tau protein and S100B. Notably, AFC levels may indicate HIE severity, emphasizing the potential significance of early AFC assessment in clinical management.

Source: bmcpediatr.biomedcentral.com/articles/10.1186/s12887-024-04663-9