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Pediatr Res. 2014 Jun;75(6):781-7. doi: 10.1038/pr.2014.41. Epub 2014 Apr 10.

Elevated blood levels of inflammation-related proteins are associated with an attention problem at age 24 mo in extremely preterm infants.

Author information

1
Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina.
2
Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts.
3
Department of Pediatrics, Boston Medical Center, Boston, Massachusetts.
4
Department of Neurology, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts.
5
Department of Medicine, Boston Children's Hospital, Boston, Massachusetts.
6
Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts.
7
1] Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts [2] Perinatal Neuroepidemiology Unit, Hannover Medical School, Hannover, Germany.

Abstract

BACKGROUND:

Extremely preterm birth is associated with subsequent behavioral problems. We hypothesized that perinatal systemic inflammation, a risk factor for cerebral white matter injury and cognitive impairment, is associated with behavior problems observed at 2 y.

METHODS:

In a cohort of 600 children born before 28 wk gestation, we measured 25 inflammation-related proteins in blood collected on postnatal days 1, 7, and 14, and identified behavior problems using parent responses to the Child Behavior Checklist for Ages 1.5-5 (CBCL/1.5-5) at 2 y of age. A persistent or recurrent protein elevation was defined as a concentration in the highest quartile (for gestational age and postnatal age) on at least 2 d ~1 wk apart. Behavior problems were defined by CBCL/1.5-5 subscale scores at or above the 93 rd percentile.

RESULTS:

A single-day elevation of intercellular adhesion molecule-3 was associated with an increased risk of an attention problem, as were persistent or recurrent elevations of myeloperoxidase, interleukin-6, tumor necrosis factor-RI, interleukin-8, intercellular adhesion molecule-3, vascular endothelial growth factor-R1, and vascular endothelial growth factor-R2. These associations persisted among infants without white matter injury and cognitive impairment.

CONCLUSION:

Among children born extremely prematurely, recurrent, or persistent elevations of inflammation-related proteins in blood during in the first two postnatal weeks are associated with an attention problem at age 2 y.

PMID:
24614800
PMCID:
PMC4429865
DOI:
10.1038/pr.2014.41
[Indexed for MEDLINE]
Free PMC Article

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