Background Diagnosis of perinatal hypoxic-ischemic encephalopathy (HIE) and early prediction neurological outcome is important and difficult. The aim of this study is to determine the value of neuron specific enolase (NSE) and lactate dehydrogenase (LDH) analysis in blood serum (BS) and cerebrospinal fluid (CSF) for evaluating severity HIE and predicting long term outcome in nenates with perinatal asphyxia.
Method 90 neonates (>32 weeks gestation) with perinatal HIE were enrolled prospectively. Perinatal HIE was categorised into three stages according Sarnat and Sarnat clinical scoring system and changes seen on amplitude integrated electroencephalography. NSE and LDH analysis in BS and CSF were taken during first 48h of age. Neurodevelopment outcome was assessed at 12 months of corrected gestational age using Denver Developmental Screening Test.
Results Concentrations of NSE and LDH in CSF were significantly higher in neonates with advanced stage of HIE and corresponded well with subsequent neurodevelopment outcome (p<0.01). Concentrations of LDH in BS were significantly higher in neonates with advanced stage of HIE and corresponded well with MODS (p<0.01) and subsequent neurodevelopment outcome (p<0.01) while concentrations of NSE in BP were no significantly higher in neonates with advanced stage of HIE (p>0.5).
Conclusions NSE and LDH analysis in CSF are accurate diagnostic tool for assessing extension of hypoxic-ischemic brain damage and early identification neonates with perinatal HIE who are at high risk of developmental delay. LDH analysis in BP also might offer an inexpensive, safe and simple prognostic tests for evaluating nenates with perinatal HIE.