Cytokines and posthemorrhagic ventricular dilation in premature infants.

Academic Article

Abstract

  • OBJECTIVE: To determine in extremely low-birth-weight infants if elevated blood interferon-γ (IFN-γ), interleukin (IL)-1β, IL-18, tumor necrosis factor-α (TNF-α), and transforming growth factor-β are associated with need for shunt following severe intraventricular hemorrhage (IVH) or with ventricular dilation following milder grades/no IVH. STUDY DESIGN: Whole blood cytokines were measured on postnatal days 1, 3, 7, 14, and 21. Maximum IVH grade in the first 28 days, and shunt surgery or ventricular dilation on subsequent ultrasound (28 days' to 36 weeks' postmenstrual age) were determined. RESULTS: Of 902 infants in the National Institute of Child Health and Human Development Neonatal Research Network Cytokine study who survived to 36 weeks or discharge, 3.1% had shunts. Of the 12% of infants with severe (grade III to IV) IVH, 26% had a shunt associated with elevated TNF-α. None of the infants without IVH (69%) or with grade I (12%) or II (7%) IVH received shunts, but 8.4% developed ventricular dilation, associated with lower IFN-γ and higher IL-18. CONCLUSION: Statistically significant but clinically nondiscriminatory alterations in blood cytokines were noted in infants with severe IVH who received shunts and in those without severe IVH who developed ventricular dilation. Blood cytokines are likely associated with brain injury but may not be clinically useful as biomarkers for white matter damage.
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    Keywords

  • Cerebral Hemorrhage, Cerebral Ventricles, Cytokines, Dilatation, Pathologic, Female, Humans, Infant, Extremely Low Birth Weight, Infant, Newborn, Infant, Premature, Male, Prospective Studies, Severity of Illness Index, Ultrasonography, Ventriculoperitoneal Shunt
  • Digital Object Identifier (doi)

    Author List

  • Ambalavanan N; Carlo WA; McDonald SA; Das A; Schendel DE; Thorsen P; Hougaard DM; Skogstrand K; Higgins RD; Cytokine and Generic Database Subcommittees of the Eunice Kennedy Shriver National Institute of Child Health Human Development Neonatal Research Network
  • Start Page

  • 731
  • End Page

  • 740
  • Volume

  • 29
  • Issue

  • 9