Among Children Born Extremely Preterm a Higher Level of Circulating Neurotrophins Is Associated with Lower Risk of Cognitive Impairment at School Age

Details

• Journal Article:
  J Pediatr
• Personal Author:
  Kuban, Karl C. K. ; Heeren, Timothy ; O’Shea, T. Michael ; Joseph, Robert M. ; Fichorova, Raina N. ; Douglass, Laurie ; Jara, Hernan ; Frazier, Jean A. ; Hirtz, Deborah ; Taylor, H. Gerry ; Rollins, Julie Vanier ; Paneth, Nigel
  More +
• Corporate Authors:
  ELGAN Study Investigators
• Description:
  Objectives ; To test the hypothesis that higher blood levels of neurotrophic proteins (proteins that support neuronal survival and function) in the first 2 weeks of life are associated with a lower risk of cognitive impairment at 10 years. ; Study design ; We evaluated 812 10-year-old children with neonatal blood specimens enrolled in the multicenter prospective Extremely Low Gestational Age Newborn Study, assessing 22 blood proteins collected on 3 days over the first 2 weeks of life. Using latent profile analysis, we derived a cognitive function level based on standardized cognitive and executive function tests. We defined high exposure as the top quartile neurotrophic protein blood level on ≥2 days either for ≥4 proteins or for a specific cluster of neurotrophic proteins (defined by latent class analysis). Multinomial logistic regression analyzed associations between high exposures and cognitive impairment. ; Results ; Controlling for the effects of inflammatory proteins, persistently elevated blood levels of ≥4 neurotrophic proteins were associated with reduced risk of moderate (OR, 0.35; 95% CI, 0.18–0.67) and severe cognitive impairment (OR, 0.22; 95% CI, 0.09–0.53). Children with a cluster of elevated proteins including angiopoietin 1, brain-derived neurotrophic factor, and regulated upon activation, normal T-cell expressed, and secreted had a reduced risk of adverse cognitive outcomes (OR range, 0.31–0.6). The risk for moderate to severe cognitive impairment was least with 0–1 inflammatory and >4 neurotrophic proteins. ; Conclusions ; Persisting elevations of circulating neurotrophic proteins during the first 2 weeks of life are associated with lowered risk of impaired cognition at 10 years of age, controlling for increases in inflammatory proteins.
• Subjects:
  • Article
  • Angiopoietin-1
  • Brain-Derived Neurotrophic Factor
  • Chemokine CCL5
  • Child
  • Child Development
  • Cognition
  • Cognition Disorders
  • Executive Function
  • Female
  More +
• Source:
  J Pediatr. 201:40-48.e4
• DOI:
  http://dx.doi.org/10.1016/j.jpeds.2018.05.021
• Pubmed ID:
  30029870
• Pubmed Central ID:
  PMC6684153
• Document Type:
  Text ; Journal Article
• Funding:
  R01 HD092374/NICHD NIH HHS/National Institute of Child Health & Human Development/United States ; U01 NS040069/NINDS NIH HHS/National Institute of Neurological Disorders and Stroke/United States ; UG3 OD023348/ODCDC CDC HHS/Office of the Director/United States ; UH3 OD023348/ODCDC CDC HHS/Office of the Director/United States
• Genre:
  Journal Article
• Volume:
  201
• Download URL:
  https://stacks.cdc.gov/view/cdc/80519/cdc_80519_DS1.pdf
• File Type:
  [PDF - 528.32 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:e06fea42b16640d8b49e11cb2d44fe97c09c44275f046e242e4f1da046585e763806c86f6fa610ec8b384254dc323e2fa82d1f42e7774b70c7e520153ed163e9