The role of perINatal factors IN formatION OF neurologICAL status of early age chILdren Hüseynova S.A. PhD, Scientific Research Institute of Obstetrics and Gynecology

Perinatal hypoxic-ischemic brain injury is a major cause of neonatal death and long-term disability; Approxi­mately 15–25% of newborns with hypoxic- ischemic encephalopathy (HIE) die during the postnatal period; Surviving infants are at risk for the development of severe and permanent neuropsycho­logical sequelae such as cerebral palsy, seizures, visual impairment, mental retardation, and learning and cognitive impairments Key facts

Decreased cerebral perfusion Hypoxia Hypoglycemia Severe anemia Genetic and external factors    Aetiology

Biochemical markers for prediction neurodevelopmental complications Neurospecific proteins: NSE, GFAP, S100, NR2 antıbodıes Cytokınes: IL-1β, IL-6, IL-8, IL-10, TNF α Adhesıon molecules: ICAM-1, VCAM-1 and etc Urinary Uric Acid Apopthosıs markers

NO ET-1 eNOS

Wei G, Dawson VL, Zweier JL Wei G, Dawson VL, Zweier JL. Role of neuronal and endothelial nitric oxide synthase in nitric oxide generation in the brain following cerebral ischemia. Biochim Biophys Acta. 1999 Sep 20;1455(1):23- 34. Philip K. Liu, Claudia S. Robertson, Alex Valadka. The Association Between Neuronal Nitric Oxide Synthase and Neuronal Sensitivity in the Brain After Brain Injury. Ann NY Acad Sci. May 2002; 962: 226- 241 Huseynova S.A. et all. Altered endothelial nitric oxide synthesis in preterm and small for gestational age infants. Pediatrics International,  08 October 2014.

neurodevelopmental disorders during early age period vascular tone regulators of peripheral blood during early days of neonatal period

Endothelial function Neuronal injury Nitric oxide (NO) Endothelin-1(ET-1) Endothelial nitric oxide synthase (eNOS) Neuronal injury Neuron specific enolase (NSE) antibodies against NR2 subunits of glutamate receptors (ANR2)

Mean total eNOS and NO values in preterm infants with HIE Mean total eNOS and NO values in preterm infants with HIE. Blue bars show results from days 1–3 and red bars show results from days 5–7. * p < 0.05 compared with the control group.

NO/eNOS ratios in preterm infants with HIE. p < 0 NO/eNOS ratios in preterm infants with HIE. * p < 0.05 compared with the control group.

Spearman rank-order correlation between NO/eNOS ratio and NSE in preterm infants with HIE (r = 0,67; p = 0.001).

Peripheral vasoregulatory markers in the early neonatal period in preterm infants with neurodevelopmental disorders Blue bars show the results from days 1– 3 and red bars show the results from days 5–7. Control 1: data from infants with HIE who did not develop a ND; Control 2: data from healthy infants. * p < 0.05 compared with Control 1; ^ p < 0.05 compared with Control 2.

Relatıonshıp between endothelal actıvıty markers and early age NDD X2 WALD p ODD/Ratio EXP Cİ eNOS, İU/ml -0,715 2,894 0,08 0,489 0,215 1,115 NO, mmol/l 0,059 0,761 0,383 1,061 0,929 1,213 Endotelin-1, pg/ml   -0,27 1,215 0,270 0,764 0,473 1,233

LIMITATIONS It was not determıned all types of NOS (ıNOS, nNOS) The amount of chıldren wıth moderate to severe NDD was not enough for comprehensıve ınterpretatıon and relıable statıstıcal results

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