Serum activin A as a predictor of intraventricular hemorrhage in preterm neonates

Serum Activin A as Brain Injury Biomarker in the First Three Days of Life. A Prospective Case—Control Longitudinal Study in Human Premature Neonates

“…Our study is in line with previous studies [16][17][18]36], which demonstrated that activin A levels in PNs, which will develop later on NBI, differ significantly during the first days of life when compared to neonates without NBI. Furthermore, similar to prior studies, we found a correlation between activin A levels and the severity of NBI; neonates in our study that had grade II-IV IVH or died due to severe IVH had significantly higher levels of serum activin A when compared to neonates without or with grade I NBI [16,36].…”

“…Our study is in line with previous studies [16][17][18]36], which demonstrated that activin A levels in PNs, which will develop later on NBI, differ significantly during the first days of life when compared to neonates without NBI. Furthermore, similar to prior studies, we found a correlation between activin A levels and the severity of NBI; neonates in our study that had grade II-IV IVH or died due to severe IVH had significantly higher levels of serum activin A when compared to neonates without or with grade I NBI [16,36]. Interestingly, considering our results on S100B [22], in the same study population and during the same period of neonatal life, serum activin A seems to demonstrate a slow response to NBI, as it rises on either the 2nd or the 3rd day of life in PNs with severe NBI.…”

“…In the study by Shahid et al [16], a comparison between the NBI groups showed that there is a strong correlation between high activin A levels and severe NBI, not only on the 3rd day of life but in venous cord blood and amniotic fluid as well. Similar results were reported by Abdel Wahed et al [36], where a positive correlation between serum activin A concentration and grading of IVH was observed.…”

“…Nevertheless, it is worth mentioning that there is a great heterogeneity between similar studies and ours regarding the studied population, focusing mainly on the type and/or on the grade of NBI and the type of biological fluid used in each study. The majority of previous studies refer to premature neonatal population with IVH [17,18,36], while only one study refers to neonates with PVL [16]. However, only the present study provides results on subgroup analysis comparing the PVL or the IVH group with the control group separately.…”

“…However, only the present study provides results on subgroup analysis comparing the PVL or the IVH group with the control group separately. Regarding the biological fluids used in similar studies, apart from peripheral blood, activin A levels have also been evaluated in umbilical artery/vein plasma or serum [16][17][18][19][20]36], amniotic fluid [16] and urine [10]. In all the aforementioned studies, activin A was detected in higher concentrations in PNs with NBI.…”