1. 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

2. 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

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

4. 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

5. NO
ET-1
eNOS

6. 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 Sep 20;1455(1):
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:
Huseynova S.A. et all. Altered endothelial nitric oxide synthesis in preterm and small for gestational age infants. Pediatrics International,  08 October 2014.

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

8. 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)

9. 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.

10. 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.

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

12. 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 < compared with Control 2.

13. Relatıonshıp between endothelal actıvıty markers and early age NDDX2
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

14. 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

15. THANK YOU