Brain insults, including neurotrauma, infection, and perinatal injuries such as hypoxic ischemic encephalopathy, generate inflammation in the brain. These inflammatory cascades induce a wide spectrum of cytokines, which can cause neuron degeneration, have neurotoxic effects on brain tissue, and lead to the development of seizures, even if they are subclinical and occur at birth. Cytokines are secreted by the glial cells of the central nervous system and they function as immune system mediators. Cytokines can be proinflammatory or anti-inflammatory. Interleukin (IL)-1beta and IL-8 are proinflammatory cytokines that activate additional cytokine cascades and increase seizure susceptibility and organ damage, whereas IL-1 receptor antagonist and IL-10 act as anti-inflammatory cytokines that have protective and anticonvulsant effects. Therefore, the immune system and its associated inflammatory reactions appear to play an important role in brain damage. Whether cytokine release is relevant for the processes of epileptogenesis and antiepileptogenesis, and whether epileptogenesis could be prevented by immunomodulatory treatment should be addressed in future clinical studies. Furthermore, early detection of brain damage and early intervention are essential for the prevention of disease progression and further neurological complications. Therefore, cytokines might be useful as biomarkers for earlier detection of brain damage in high-risk infants.
Biomarkers ; Brain ; Central Nervous System ; Cytokines ; Disease Progression ; Early Intervention (Education) ; Humans ; Hypoxia-Ischemia, Brain ; Immune System ; Infant ; Inflammation ; Interleukin 1 Receptor Antagonist Protein ; Interleukin-1 ; Interleukin-10 ; Interleukin-8 ; Interleukins ; Nerve Degeneration ; Neuroglia ; Parturition ; Seizures

Purpose: Meconium aspiration syndrome (MAS) occurs when aspiration of meconium itself or meconium-stained amniotic fluid enters into the airways. The relationship between MAS and how they affect the respiratory outcome after recovery from MAS remains unknown. The purpose of this study was to determine the type of lower respiratory tract illness (LRTI) in those surviving MAS survivors and to find out whether any clinical findings or treatment determine the type of LRTI. Methods: We used the Catholic Medical Center’s clinical data warehouse to review data from 4 university hospitals. We first included 1,331 newborns born between March 2016 and February 2021 with diagnostic codes including labor and delivery complicated by fetal stress (distress), intrauterine hypoxia, and neonatal aspiration syndromes. We finally included 239 patients who visited the outpatient clinic with diagnosis of pneumonia, acute bronchitis, acute bronchiolitis, and asthma, according to the Korean Standard Classification of Diseases. Results: We observed a significantly higher number and fraction of eosinophils at birth in the bronchitis group. We also found significantly lower levels of white blood cells in the asthma group. After a regression analysis, we found that mechanical ventilation and steroid usage for treatment for of MAS was significantly related to bronchitis, and that antibiotics treatment acted as a protective factor for bronchiolitis. Conclusion Laboratory findings and treatment at birth in infants with MAS appear to have impact on determining LRTI in those who survived MAS.

We report the case of an infant with a 4q35.1 deletion with 10p duplication. This mutation is rarely reported in the literature and has been found to have variable clinical findings, often including developmental delay. In this case, the condition was detected by chromosomal microarray analysis after initial manifestation of a feeding problem and developmental delay. Minor dysmorphic features with abnormal neurological examination led to further evaluation. The father’s chromosome complement was 46, XY, t(4;10)(q35;p12.2). Parental balanced translocation can go unrecognized, because affected individuals are often phenotypically healthy until they have fertility issues such as recurrent miscarriages or children with severe congenital disorders. Genetic diagnoses help to establish a clear family genetic background that permits the development of clear treatment strategies. Prenatal counseling can also help to understand the possible risks associated with pregnancy or future child planning.

BACKGROUND: The aim of this study was to observe long-term outcomes of very low birth weight infants (VLBWIs) born between 2013 and 2014 in Korea, especially focusing on neurodevelopmental outcomes. METHODS: The data were collected from Korean Neonatal Network (KNN) registry from 43 and 54 participating units in 2013 and 2014, respectively. A standardized electronic case report form containing 30 items related to long-term follow up was used after data validation. RESULTS: Of 2,660 VLBWI, the mean gestational age and birth weight were 291/7 ± 26/7 weeks and 1,093 ± 268 g in 2013 and 292/7 ± 26/7 weeks and 1,125 ± 261 g in 2014, respectively. The post-discharge mortality rate was 1.2%–1.5%. Weight < 50th percentile was 46.5% in 2013 and 66.1% in 2014. The overall prevalence of cerebral palsy among the follow up infants was 6.2% in 2013 and 6.6% in 2014. The Bayley Scales of Infant Developmental Outcomes version II showed 14%–25% of infants had developmental delay and 3%–8% of infants in Bayley version III. For the Korean developmental screening test for infants and children, the area “Further evaluation needed” was 5%–12%. Blindness in both eyes was reported to be 0.2%–0.3%. For hearing impairment, 0.8%–1.9% showed bilateral hearing loss. Almost 50% were readmitted to hospital with respiratory illness as a leading cause. CONCLUSION: The overall prevalence of long-term outcomes was not largely different among the VLBWI born between 2013 and 2014. This study is the first large national data study of long-term outcomes.
Birth Weight ; Blindness ; Cerebral Palsy ; Child ; Child Development ; Follow-Up Studies ; Gestational Age ; Hearing Loss ; Hearing Loss, Bilateral ; Humans ; Incidence ; Infant* ; Infant, Very Low Birth Weight* ; Korea ; Mass Screening ; Mortality ; Prevalence ; Weights and Measures