Vaginal Delivery Is Associated with Neurochemical Evidence of Increased Neuroaxonal Remodelling in Infants from the KUNO-Kids Health Study: Cross-Sectional Analysis.

Pregnancy Infant, Newborn Humans Female Cross-Sectional Studies Cesarean Section Prospective Studies
Biomarker Birth mode Central nervous system Neuron Serum

Journal

Neonatology
ISSN: 1661-7819
Titre abrégé: Neonatology
Pays: Switzerland
ID NLM: 101286577

Informations de publication

Date de publication:
2022
Historique:
received: 11 03 2022
accepted: 14 07 2022
pubmed: 16 9 2022
medline: 15 12 2022
entrez: 15 9 2022
Statut: ppublish

Résumé

Little is known about neonatal brain plasticity or the impact of birth mode on neurointegrity. As a reflection of neuroaxonal damage, the neuronal structural protein neurofilament light chain (NfL) has emerged as a highly specific biomarker. Our purpose was to test the hypothesis that vaginal delivery is associated with increased NfL in neonates. NfL concentrations were measured using single-molecule array immunoassay in umbilical cord serum from healthy term neonates enrolled in the prospective KUNO-Kids Health Study. NfL values were investigated for independent influencing factors using linear and logistic models, followed by post hoc propensity score-matching. Of 665 neonates, n = 470 (70.7%) were delivered vaginally and n = 195 (29.3%) by cesarean section. Median serum NfL was significantly higher after vaginal delivery 14.4 pg/mL (11.6-18.5) compared to primary 7.5 pg/mL (6.1-8.9) and secondary cesarean delivery 9.3 pg/mL (7.5-12.0). Multivariable logistic regression models showed delivery mode and gestational age to be independently associated with NfL. Propensity score-matching analysis confirmed that assisted vaginal delivery generated higher NfL compared to vaginal (non-assisted), while lowest levels were associated with cesarean section. Our data confirm the significant impact of birth mode on neonatal NfL levels. The persistence of these differences and their potential long-term impact have yet to be investigated.

Identifiants

DOI: 10.1159/000526472 PMID: 36108619
pubmed: 36108619
pii: 000526472
doi: 10.1159/000526472
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

769-776

Informations de copyright

© 2022 The Author(s). Published by S. Karger AG, Basel.

Auteurs

Katja Kürner (K)

Department of Neonatology, University Children's Hospital of Regensburg (KUNO), Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany.

Katharina Goeral (K)

Division of Neonatology, Intensive Care and Pediatric Neurology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria, katharina.goeral@meduniwien.ac.at.

Andrew Atkinson (A)

Department of Paediatric Pharmacology and Pharmacometrics, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland.

Susanne Brandstetter (S)

University Children's Hospital of Regensburg (KUNO), Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany.
Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany.

Antoaneta A Toncheva (AA)

University Children's Hospital of Regensburg (KUNO), Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany.

Michael Kabesch (M)

Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany.
Department of Pediatric Pneumology and Allergy, University Children's Hospital of Regensburg (KUNO), Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany.

Christian Apfelbacher (C)

Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany.
Institute of Social Medicine and Health Systems Research, Otto von Guericke-University Magdeburg, Magdeburg, Germany.

Michael Melter (M)

University Children's Hospital of Regensburg (KUNO), Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany.
Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany.

Birgit Seelbach-Göbel (B)

University Department of Obstetrics and Gynecology at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany.

Angelika Berger (A)

Division of Neonatology, Intensive Care and Pediatric Neurology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria.

Jens Kuhle (J)

Departments of Biomedicine and Clinical Research, Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, Basel, Switzerland.

Sven Wellmann (S)

Department of Neonatology, University Children's Hospital of Regensburg (KUNO), Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany.

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Classifications MeSH

questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques de la reproduction › Reproduction › Grossesse › Vaginal Delivery Is Associated with...
questionsmedicales.fr › Personnes › Tranches d'âge › Nourrisson › Nouveau-né › Vaginal Delivery Is Associated with...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Vaginal Delivery Is Associated with...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études transversales › Vaginal Delivery Is Associated with...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie obstétrique › Accouchement (procédure) › Césarienne › Vaginal Delivery Is Associated with...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Vaginal Delivery Is Associated with...