No biological marker of brain injury in the preterm infant is available. Serum fatty acid-binding protein (FABP) appears to be a valid serum biomarker for the early diagnosis of stroke1 and of tissue damage.2
This studied aimed to correlate serum FABP in preterm infants with brain injury assessed by magnetic resonance imaging (MRI).
54 preterms <30 weeks of gestation and/or <1500 g were studied. Serum FABP was measured at 24 h and 72 h of life. MRI at term equivalent was performed. Levels of FABP were compared with clinical diagnosis of asphyxia, between deceased and surviving babies, with radiological qualitative assessment of the MRI and with a score of white matter injury.3
The mean gestational age was 27.7±1.3 weeks and the mean birthweight was 1005.9±242.2 g. A significant increase of FABP at 24 h (P24H = 0.014) and 72 h (P72H = 0.006) was seen between asphyxiated and normal babies and between deceased and survivors (P24H = 0.001, P72H = 0.003). The infants with cerebral lesions at term on qualitative assessment of MRI showed an increased level of FABP at 24 h (P24H = 0.006) compared to the non-injured ones. Preterms with abnormal white matter score of injury at term3 showed a significant increase in FABP at 24 h (P24H = 0.044) compared to preterms with normal score.
FABP appears to be an early marker of cerebral lesions objectified by MRI at term in the preterm infant. It could be an approachable means to identify preterms that could benefit from future neuroprotective intervention.