Elevated Endogenous Erythropoietin Concentrations Are Associated with Increased Risk of Brain Damage in Extremely Preterm Neonates
Author
Korzeniewski, Steven J.; Allred, Elizabeth N.; Logan, J. Wells; Fichorova, Raina N.; Engelke, Stephen C.; Kuban, Karl C. K.; O'Shea, T. Michael; Paneth, Nigel; Holm, Mari; Dammann, Olaf; Leviton, Alan
Abstract
Background
We sought to determine, in very preterm infants, whether elevated perinatal erythropoietin (EPO) concentrations are associated with increased risks of indicators of brain damage, and whether this risk differs by the co-occurrence or absence of intermittent or sustained systemic inflammation (ISSI).
Methods
Protein concentrations were measured in blood collected from 786 infants born before the 28th week of gestation. EPO was measured on postnatal day 14, and 25 inflammation-related proteins were measured weekly during the first 2 postnatal weeks. We defined ISSI as a concentration in the top quartile of each of 25 inflammation-related proteins on two separate days a week apart. Hypererythropoietinemia (hyperEPO) was defined as the highest quartile for gestational age on postnatal day 14. Using logistic regression and multinomial logistic regression models, we compared risks of brain damage among neonates with hyperEPO only, ISSI only, and hyperEPO+ISSI, to those who had neither hyperEPO nor ISSI, adjusting for gestational age.
Results
Newborns with hyperEPO, regardless of ISSI, were more than twice as likely as those without to have very low (< 55) Mental (OR 2.3; 95% CI 1.5-3.5) and/or Psychomotor (OR 2.4; 95% CI 1.6-3.7) Development Indices (MDI, PDI), and microcephaly at age two years (OR 2.4; 95%CI 1.5-3.8). Newborns with both hyperEPO and ISSI had significantly increased risks of ventriculomegaly, hemiparetic cerebral palsy, microcephaly, and MDI and PDI < 55 (ORs ranged from 2.2-6.3), but not hypoechoic lesions or other forms of cerebral palsy, relative to newborns with neither hyperEPO nor ISSI.
Conclusion
hyperEPO, regardless of ISSI, is associated with elevated risks of very low MDI and PDI, and microcephaly, but not with any form of cerebral palsy. Children with both hyperEPO and ISSI are at higher risk than others of very low MDI and PDI, ventriculomegaly, hemiparetic cerebral palsy, and microcephaly.
Subject
Date
2015-03
Citation:
APA:
Korzeniewski, Steven J., & Allred, Elizabeth N., & Logan, J. Wells, & Fichorova, Raina N., & Engelke, Stephen C., & Kuban, Karl C. K., & O'Shea, T. Michael, & Paneth, Nigel, & Holm, Mari, & Dammann, Olaf, & Leviton, Alan. (March 2015).
Elevated Endogenous Erythropoietin Concentrations Are Associated with Increased Risk of Brain Damage in Extremely Preterm Neonates.
PLoS ONE,
10(3),
1-
18. Retrieved from
http://hdl.handle.net/10342/5750
MLA:
Korzeniewski, Steven J., and Allred, Elizabeth N., and Logan, J. Wells, and Fichorova, Raina N., and Engelke, Stephen C., and Kuban, Karl C. K., and O'Shea, T. Michael, and Paneth, Nigel, and Holm, Mari, and Dammann, Olaf, and Leviton, Alan.
"Elevated Endogenous Erythropoietin Concentrations Are Associated with Increased Risk of Brain Damage in Extremely Preterm Neonates". PLoS ONE.
10:3. (1-18),
March 2015.
June 29, 2024.
http://hdl.handle.net/10342/5750.
Chicago:
Korzeniewski, Steven J. and Allred, Elizabeth N. and Logan, J. Wells and Fichorova, Raina N. and Engelke, Stephen C. and Kuban, Karl C. K. and O'Shea, T. Michael and Paneth, Nigel and Holm, Mari and Dammann, Olaf and Leviton, Alan,
"Elevated Endogenous Erythropoietin Concentrations Are Associated with Increased Risk of Brain Damage in Extremely Preterm Neonates," PLoS ONE 10, no.
3 (March 2015),
http://hdl.handle.net/10342/5750 (accessed
June 29, 2024).
AMA:
Korzeniewski, Steven J., Allred, Elizabeth N., Logan, J. Wells, Fichorova, Raina N., Engelke, Stephen C., Kuban, Karl C. K., O'Shea, T. Michael, Paneth, Nigel, Holm, Mari, Dammann, Olaf, Leviton, Alan.
Elevated Endogenous Erythropoietin Concentrations Are Associated with Increased Risk of Brain Damage in Extremely Preterm Neonates. PLoS ONE.
March 2015;
10(3):
1-18.
http://hdl.handle.net/10342/5750. Accessed
June 29, 2024.
Collections