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Perinatal blood biomarkers for the identification of brain injury in very low birth weight growth-restricted infants



To determine if blood biomarkers measured at delivery and shortly after birth can identify growth-restricted infants at risk for developing severe brain injury.

Study design

In a cohort of very low birth weight neonates, fetal growth restricted (FGR) (birth weight <10%) were compared to non-FGR neonates, and within the FGR group those with brain injury were compared to those without. Biomarkers were measured in cord blood at delivery, and daily for the 1st 5 days of life.


FGR was associated with significantly higher levels of interleukin (IL)-6, IL-8, IL-10, and lower levels of vascular endothelial growth factor (VEGF). FGR and brain injury were associated with significantly higher levels of IL-6, IL-8, IL-10, and glial fibrillary acidic protein (GFAP).


Interleukins may be involved in a common pathway contributing to both the development of growth restriction and brain injury, and GFAP may help identify brain injury within this growth-restricted group.

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Funded by NICHD R01HD086058 “Adult Biomarkers in Neonatal Brain Injury and Development”.

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Correspondence to Ernest M. Graham.

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The authors declare no competing interests.

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Under a license agreement between ImmunArray Ltd. and the Johns Hopkins University, the University and Dr. Everett are entitled to royalties on an invention described in this study and discussed in this publication. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies.


Biomarkers measured in cord blood at delivery and neonatal serum after birth may identify growth-restricted infants at risk for developing severe brain injury.

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Yue, S.L., Eke, A.C., Vaidya, D. et al. Perinatal blood biomarkers for the identification of brain injury in very low birth weight growth-restricted infants. J Perinatol (2021).

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