Background

New biomarkers that predict later neurodevelopmental morbidity are needed. This study evaluated the associations between umbilical cord serum erythropoietin (us-EPO) and neurodevelopmental morbidity by the age of 2–6.5 years in a Finnish cohort.

Methods

This study included 878 non-anomalous children born alive in 2012 to 2016 in Helsinki University Hospitals and whose us-EPO concentration was determined at birth. Data of these children were linked to data from the Finnish Medical Birth Register and the Finnish Hospital Discharge Register. Neurodevelopmental morbidity included cerebral palsy, epilepsy, intellectual disability, autism spectrum disorder, sensorineural defects, and minor neurodevelopmental disorders.

Results

In the cohort including both term and preterm children, us-EPO levels correlated with gestational age (r = 0.526) and were lower in premature children. High us-EPO levels (>100 IU/l) were associated with an increased risk of severe neurodevelopmental morbidity (OR: 4.87; 95% CI: 1.05–22.58) when adjusted for the gestational age. The distribution of us-EPO levels did not differ in children with or without the later neurodevelopmental diagnosis.

Conclusions

Although high us-EPO concentration at birth was associated with an increased risk of neurodevelopmental morbidity in early childhood, the role of us-EPO determination in clinical use appears to be minor.

Impact

• We determined whether endogenous umbilical cord serum erythropoietin would be a new useful biomarker to predict the risk of neurodevelopmental morbidity.

• This study evaluated the role of endogenous erythropoietin at birth in neurodevelopmental morbidity with a study population of good size and specific diagnoses based on data from high-quality registers.

• Although high umbilical cord serum erythropoietin concentration at birth was associated with an increased risk of neurodevelopmental morbidity in early childhood, the clinical value of erythropoietin determination appears to be minor.

中文翻译：

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出生时的内源性促红细胞生成素与儿童早期的神经发育发病率有关

背景

需要预测后期神经发育发病率的新生物标志物。本研究评估了芬兰队列中 2-6.5 岁时脐带血清促红细胞生成素 (us-EPO) 与神经发育发病率之间的关联。

方法

这项研究包括 2012 年至 2016 年在赫尔辛基大学医院活着出生的 878 名非异常儿童，他们的 us-EPO 浓度在出生时测定。这些孩子的数据与芬兰医学出生登记册和芬兰医院出院登记册的数据相关联。神经发育发病率包括脑瘫、癫痫、智力障碍、自闭症谱系障碍、感觉神经缺陷和轻微的神经发育障碍。

结果

在包括足月儿和早产儿的队列中，us-EPO 水平与胎龄相关（r  = 0.526）并且早产儿的水平较低。当调整胎龄时，高 us-EPO 水平（>100 IU/l）与严重神经发育发病率的风险增加相关（OR：4.87；95% CI：1.05-22.58）。在有或没有后来的神经发育诊断的儿童中，us-EPO 水平的分布没有差异。

结论

尽管出生时的高 us-EPO 浓度与儿童早期神经发育发病率的风险增加有关，但 us-EPO 测定在临床应用中的作用似乎很小。

影响

• 我们确定内源性脐带血清促红细胞生成素是否会成为预测神经发育发病风险的新有用生物标志物。

• 本研究评估了出生时内源性促红细胞生成素在神经发育发病率中的作用，研究人群规模良好，基于高质量登记数据的特定诊断。

• 虽然出生时高浓度的脐带血清促红细胞生成素与儿童早期神经发育发病率的风险增加有关，但促红细胞生成素测定的临床价值似乎很小。