Abstract
The classical criteria of asphyxia, Apgar score and metabolic acidosis are poor predictors of perinatal brain damage. Our aim was to assess if AVP (released after stress or asphyxia), EP (synthesized after hypoxic stimulus), and HX (an ATP degradation product) are better predictors.
We measured AVP and HX in umbilical arterial (UA) and EP in venous plasma of 62 infants born after preeclampsia pregnancy (PP), 31 acutely asphyxiated (AA) infants with 5-min Apgar <7 and/or UA-pH ≤7.05, and 38 control infants. Neurologic follow-up at 2 yr included Bayley score. Severe abnormality (S) was found in 4 PP and 5 AA infants, mild (M) in 12 and 6. High AVP was found only in normal AA infants (geom mean;95% conf: 303; 146-633 pg/ml); M or S did not differ from controls (24;8-75). EP was high in PP infants regardless of outcome: normal (102;69-153), M (100;37-270), and S (84;19-378 mU/ml). AA infants with S outcome had higher EP (67:33-137) than M or normal or controls (38;32-46). HX in PP infants was similar to controls. Normal AA infants had higher HX (24;17-33 μmol/l) than controls (12;10-16).
We conclude that neither AVP nor HX predicts brain damage. High EP after normal pregnancy, but not after preeclampsia, carries a risk for CP or death.
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Ruth, V., Raivio, K. 22 PREDICTION OF PERINATAL BRAIN DAMAGE BY CORD PLASMA VASOPRESSIN (AVP), ERYTHROPOIETIN (EP), AND HYPO-XANTHINE (HX). Pediatr Res 24, 264 (1988). https://doi.org/10.1203/00006450-198808000-00048
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DOI: https://doi.org/10.1203/00006450-198808000-00048