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Brain, Vol. 126, No. 5, 1224-1230, May 2003
© 2003 Guarantors of Brain
doi: 10.1093/brain/awg116

Non protein bound iron as early predictive marker of neonatal brain damage

Giuseppe Buonocore, Serafina Perrone, Mariangela Longini, Patrizia Paffetti, Piero Vezzosi, Maria Gabriella Gatti and Rodolfo Bracci

Department of Paediatrics, Obstetrics and Reproductive Medicine, University of Siena, Italy

Correspondence to: Professor Giuseppe Buonocore, MD, Department of Paediatrics, Obstetrics and Reproductive Medicine, University of Siena, Policlinico ‘Le Scotte’, V. le Bracci 36, 53100 Siena, Italy E-mail: buonocore{at}unisi.it

Of the approximately 130 million births worldwide each year, four million infants will suffer from birth asphyxia and, of these, one million will die and a similar number will develop serious sequelae. Before being able to develop effective interventions, a better understanding of the pathophysiological mechanisms leading to brain injury and an early identification of babies at high risk for brain injury are required. This study tests the predictivity of traditional and new markers of foetal oxidative stress in relation to neurodevelopmental outcome in 384 newborn infants. The results indicate plasma non protein bound iron as the best early predictive marker of neurodevelopmental outcome, with 100% sensitivity and 100% specificity for good neurodevelopmental outcome at 0–1.16 µmol/l, and for poor neurodevelopmental outcome at values >15.2 µmol/l. The number of children with values between 1.16 and 15.2 were 195. Common use of this predictive marker in neonatology units will improve the ability of clinicians to identify those newborn babies who will develop neurodisability.


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