Disruption of normal intrauterine brain development is a significant consequence of premature birth and may lead to serious complications, such as neonatal brain injury (NBI). This prospective case-control longitudinal study aimed at determining the levels and prognostic value of serum activin A during the first three days of life in human premature neonates which later developed NBI. It was conducted in a single tertiary hospital and eligible participants were live-born premature (<34 weeks) neonates. Each case (n = 29) developed NBI in the form of an intraventricular haemorrhage, or periventricular leukomalacia, and was matched according to birth weight and gestational age to one neonate with normal head ultrasound scans. Serum activin A levels in both groups showed a stable concentration during the first three days of life as no difference was observed within the two groups from the first to the third day. Neonates diagnosed with NBI had significantly higher activin A levels during the first two days of life compared to control neonates and its levels correlated to the severity of NBI during the second and third day of life. Although serum activin A on the second day was the best predictor for neonates at risk to develop NBI, the overall predictive value was marginally fair (area under the ROC-curve 69.2%). Activin A, in combination with other biomarkers, may provide the first clinically useful panel for the early detection of premature neonates at high risk of NBI.

中文翻译：

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血清激活素 A 在生命的前三天作为脑损伤生物标志物。一个前瞻性案例——人类早产儿的纵向对照研究

正常子宫内大脑发育的中断是早产的一个重要后果，并可能导致严重的并发症，例如新生儿脑损伤 (NBI)。这项前瞻性病例对照纵向研究旨在确定人类早产儿出生后头三天内血清激活素 A 的水平和预后价值，这些早产儿后来发展为 NBI。它是在一家三级医院进行的，符合条件的参与者是活产早产儿（<34 周）。每种情况 ( n =29) 以脑室内出血或脑室周围白质软化的形式发展为 NBI，并根据出生体重和胎龄与一名头部超声扫描正常的新生儿相匹配。两组的血清激活素 A 水平在出生后的前三天都显示出稳定的浓度，因为从第一天到第三天，两组之间没有观察到差异。与对照组新生儿相比，被诊断为 NBI 的新生儿在出生后的前两天具有显着更高的激活素 A 水平，其水平与出生后第二天和第三天的 NBI 严重程度相关。尽管第 2 天的血清激活素 A 是有发生 NBI 风险的新生儿的最佳预测指标，但总体预测值还算公平（ROC 曲线下的面积为 69.2%）。激活素 A，结合其他生物标志物，