Background Term infants with NE of hypoxic-ischaemic origin, have been exposed to generalised oxidative injury which may cause excessive cytokine production and release in serum and CSF. Cytokine levels may correlate with severity of brain injury and aid in outcome prediction.

Objective To investigate the relationship between serum and CSF biomarkers and NE in a group of term infants exposed to perinatal hypoxia-ischaemia compared to controls.

Design/Methods Levels of serum and CSF biomarkers [VEGF, IL-8, Epo, GM-CSF] were serially measured over day 1–11 in a group of term newborns with NE and controls (serum only). These values were compared to grade of encephalopathy defined by Sarnat score.

Results Twelve control and 82 cases had serum samples collected (Grade 0 NE = 6, Grade I NE = 23, Grade II NE = 42, Grade III NE = 11). Thirty-nine infants underwent TH, 4 infants died. Controls had significantly lower serum Epo on day 1–2 compared with cases (p-values < 0.05). Grade II/III NE was significantly associated with elevated serum Epo (Day 2), IL-8 (Day 2 and 6–8) (p-values < 0.05) and with decreased VEGF (Day 1). Grade II/III NE was best predicted by Epo and IL-8 (Day 2) and VEGF (Day 1) (p-values < 0.05). CSF biomarker levels (n = 34 infants) were not significantly associated with abnormal NE grade.

Conclusions Term infants exposed to perinatal hypoxia-ischaemia have elevated levels of serum biomarkers compared to controls. Abnormal NE grade is best predicted by day 2 serum Epo and IL-8 while CSF levels were not predictive of outcome. Serum biomarkers may have a role in long term outcome prediction following NE.