Background Pro-inflammatory cytokines in both cerebrospinal fluid (CSF) and serum have been associated with abnormal neurological findings following hypoxic-ischaemic injury. Vascular endothelial growth factor (VEGF) seems to have a neuroprotective effect in adult stroke and low levels correlate with poor outcomes. We aimed to establish a correlation between serum VEGF levels and the severity of Neonatal Encephalopathy (NE).

Methods Multi-organ evaluation was carried out on infants with NE (n = 122) with a particular emphasis on neurological status and function including neuroimaging (MRI and Cranial Ultrasound) and placental pathology. Serial serum VEGF levels were measured by multiplex ELISA over the first week of life.

Results Infants with NE (n = 73) had serum VEGF levels on days 1, 2 and 3 of life that decreased as the severity of NE increased (Grade 0: n = 9, Grade 1: n = 20, Grade 2: n = 37, Grade 3: n = 7).

Infants with NE (n = 122) had an association between elevated serum VEGF levels on day 1 and histological chorioamnionitis (n = 24) (p = 0.025). The mean serum VEGF in those without chorioamnionitis was 570 ± 870pg/mL compared to 1144 ± 1129pg/mL in those with chorioamnionitis. Serial VEGF levels were significantly associated with cord anomalies (p < 0.05). VEGF did not correlate with MRI results.

Conclusions VEGF correlated with Histological Chorioamnionitis in NE and the severity of encephalopathy.