Kuerner, Katja and Goeral, Katharina and Atkinson, Andrew and Brandstetter, Susanne and Toncheva, Antoaneta A. and Kabesch, Michael and Apfelbacher, Christian and Melter, Michael and Seelbach-Goebel, Birgit and Berger, Angelika and Kuhle, Jens and Wellmann, Sven (2022) Vaginal Delivery Is Associated with Neurochemical Evidence of Increased Neuroaxonal Remodelling in Infants from the KUNO-Kids Health Study: Cross-Sectional Analysis. NEONATOLOGY, 119 (6). pp. 769-776. ISSN 1661-7800, 1661-7819
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Aim: 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. Methods: 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. Results: 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. Interpretation: 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.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | NEUROFILAMENT LIGHT-CHAIN; WOMEN; MODE; RISK; TERM; Biomarker; Birth mode; Central nervous system; Neuron; Serum |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Frauenheilkunde und Geburtshilfe (Schwerpunkt Geburtshilfe) Medicine > Lehrstuhl für Kinder- und Jugendmedizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 13 Feb 2024 10:34 |
| Last Modified: | 13 Feb 2024 10:34 |
| URI: | https://pred.uni-regensburg.de/id/eprint/57165 |
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