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    Circulating Inflammatory-Associated Proteins in the First Month of Life and Cognitive Impairment at Age 10 Years in Children Born Extremely Preterm

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    Authors
    Kuban, Karl C. K.
    Joseph, Robert M.
    O'Shea, Thomas M.
    Heeren, Timothy
    Fichorova, Raina N.
    Douglass, Laurie
    Jara, Hernan
    Frazier, Jean A.
    Hirtz, Deborah
    Rollins, Julie Vanier
    Paneth, Nigel
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    UMass Chan Affiliations
    Department of Psychiatry
    Document Type
    Journal Article
    Publication Date
    2017-01-01
    Keywords
    cognition
    extremely preterm infants
    inflammation-related proteins
    school age
    Mental and Social Health
    Pediatrics
    Psychiatry
    Psychiatry and Psychology
    
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    https://doi.org/10.1016/j.jpeds.2016.09.054
    Abstract
    OBJECTIVES: To evaluate whether in children born extremely preterm, indicators of sustained systemic inflammation in the first month of life are associated with cognitive impairment at school age. STUDY DESIGN: A total of 873 of 966 eligible children previously enrolled in the multicenter Extremely Low Gestational Age Newborn Study from 2002 to 2004 were evaluated at age 10 years. We analyzed the relationship between elevated blood concentrations of inflammation-associated proteins in the first 2 weeks ("early elevations"; n = 812) and the third and fourth week ("late elevations"; n = 532) of life with neurocognition. RESULTS: Early elevations of C-reactive protein, tumor necrosis factor-alpha, interleukin (IL)-8, intercellular adhesion molecule (ICAM)-1, and erythropoietin were associated with IQ values > 2 SD below the expected mean (ORs: 2.0-2.3) and with moderate to severe cognitive impairment on a composite measure of IQ and executive function (ORs: 2.1-3.6). Additionally, severe cognitive impairment was associated with late protein elevations of C-reactive protein (OR: 4.0; 95% CI 1.5, 10), IL-8 (OR: 5.0; 1.9, 13), ICAM-1 (OR: 6.5; 2.6, 16), vascular endothelial growth factor-receptor 2 (OR: 3.2; 1.2, 8.3), and thyroid-stimulating hormone (OR: 3.1; 1.3, 7.3). Moderate cognitive impairment was most strongly associated with elevations of IL-8, ICAM-1, and vascular endothelial growth factor-receptor 2. When 4 or more inflammatory proteins were elevated early, the risk of having an IQ < 70 and having overall impaired cognitive ability was more than doubled (ORs: 2.1-2.4); the presence of 4 or more inflammatory protein elevated late was strongly linked to adverse cognitive outcomes (ORs: 2.9-4.8). CONCLUSIONS: Extremely preterm children who had sustained elevations of inflammation-related proteins in the first postnatal month are more likely than extremely preterm peers without such elevations to have cognitive impairment at 10 years.
    Source
    J Pediatr. 2017 Jan;180:116-123.e1. Epub 2016 Oct 24. Link to article on publisher's site
    DOI
    10.1016/j.jpeds.2016.09.054
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/46233
    PubMed ID
    27788929
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jpeds.2016.09.054
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