Background Brain injury and inflammation are common mechanisms of disease in preterm infants. VEGF is an endothelial growth factor which has been shown to be neuro-protective in adult stroke. Infants less than 32 weeks’ gestation who suffer from respiratory distress syndrome (RDS) have been shown to have significantly lower VEGF levels than those without RDS. However little is known about the mechanisms of VEGF in the premature brain.

Aim We aimed to investigate the relationship between brain injury and chorioamnionitis and serum VEGF levels in preterm infants.

Methods Preterm infants <32 weeks’ gestation were recruited. Details of their demographics and neonatal intensive care unit stay were recorded, as well as cranial ultrasound and placental pathology results. Serial serum VEGF levels were measured by multiplex ELISA over the first week of life.

Results Preterm infants (n = 86) had a mean gestation of 28+4 ± 0+2 weeks and Birth weight of 1165 ± 326 kg.

Infants (n = 29) with abnormal cranial ultrasounds (n = 9) had a decreased mean VEGF level (227 ± 322 pg/mL versus normal 324 ± 528 pg/mL). Serum VEGF levels on Day 1 were significantly associated with histological chorioamnionitis (p = 0.0006). The mean serum VEGF levels were 116 ± 182 pg/mL in those without chorioamnionitis compared to 735 ± 683 pg/mL in those with chorioamnionitis.

Conclusion Elevated serum VEGF is associated with choriomanionitis in preterm infants.