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Cited by 4Neonatal and fetal brain pathologyInfant Development and Preterm CareNeonatal and Maternal Infections

The DOI matches its Crossref record; 45 of the 46 references it cites were found in a registry or an index.

Multi-organ involvement in preterm neonatal encephalopathy

Open access
Bitar, Lynn, Kota, Srinivas, Machie, Michelle, Mashat, Suleiman, Liu, Yu-Lun, Chalak, Lina F.·2025·Early Human Development
DOI 10.1016/j.earlhumdev.2025.106317PMC PMC12248653
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Abstract

BACKGROUND: Hypoxic-ischemic encephalopathy (HIE) is a complex condition resulting from oxygen deprivation at birth. As the body redirects cardiac output to protect the brain, this can lead to multiorgan dysfunction (MOD). While most previous studies traditionally focused on term neonates with HIE, our goal was to focus on preterm neonates to study the effect on organs during critical periods of brain development. We aim to assess the incidence and severity of MOD in relation to brain magnetic resonance imaging (MRI) findings and electroencephalogram (EEG) abnormalities in this vulnerable population. METHODS: Retrospective cohort review of preterm neonates (<35 weeks' gestation) with a diagnosis of neonatal encephalopathy (NE) admitted to the Neonatal Intensive Care Unit (NICU) at Parkland Hospital in Dallas between 2009 and 2023. MOD diagnosis of cardiac, renal, and liver function using clinical and laboratory markers, including echocardiography, serial troponin T, creatinine, urine output, as well as AST and ALT levels during the perinatal period. RESULTS: During the study period, 54 preterm neonates (incidence 0.4/1000) were diagnosed with HIE. All of them had one or more organ injuries and the majority suffered from MOD: 67 % had liver injury (AST 277.0 [68.0, 686.8] IU/L), 55 % had cardiac injury (Troponin T 0.3 [0.2, 0.6] Ng/mL), and 37 % had renal injury (oliguria and creatinine 1.0 [0.8, 1.3]). Those values significantly decreased from Day 1 compared to Day 3 and 6 of life. Additionally, 35 % of newborns had electrographic seizures, 68 % had a discontinuous EEG background, and 83 % had brain MRI/MRS abnormalities supporting HIE. Death occurred in 10 (19 %) due to complications from MOD. CONCLUSIONS: By revealing the significant burden of MOD in preterm infants, this study highlights the need to refine screening and management strategies. Greater vigilance of MOD is crucial for future neuroprotective strategies in this vulnerable population.

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Fig. 1. Flowchart of the study cohort selection process for preterm neonates with HIE.
Fig. 1. Flowchart of the study cohort selection process for preterm neonates with HIE.CC BY · PubMed Central
Fig. 2. Temporal trends in biomarker levels among preterm neonates with HIE.
Fig. 2. Temporal trends in biomarker levels among preterm neonates with HIE.CC BY · PubMed Central

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  1. Bitar, 2024, Key inflammatory biomarkers in perinatal asphyxia: a comprehensive review, Clin. Perinatol., 0

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Metadata

Authors
Bitar, L., Kota, S., Machie, M., Mashat, S., Liu, Y.-L., & Chalak, L. F.
Affiliations
Children's Medical Center (US)
Corresponding author
Chalak, Lina F.
ORCID
Venue
Early Human Development
Publisher
Elsevier BV
Published
2025-09
Volume
208
Pages
106317
ISSN
0378-3782 (ISSN-L)
DOI
10.1016/j.earlhumdev.2025.106317
PMC
PMC12248653
OpenAlex
W4411137514
Cited by
4
References
46
Citations by year
2026: 3 · 2025: 1
FWCI
6.03
Type
journal article
Language
en
Open access
Licence
Locations
  • Early Human Development (publishedVersion, cc-by)
  • SSRN Electronic Journal (acceptedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion, cc-by)
Funders
  • Patient-Centered Outcomes Research Institute (CER-2021C3-24763)
  • National Institute of Neurological Disorders and Stroke
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and Maternal Infections
Keywords
hypoxic-ischemic encephalopathy, preterm infants, multiple organ failure, neonatal encephalopathy, liver injury, cardiac injury, kidney injury, electrographic seizures, brain MRI abnormalities, troponin T, creatinine, neonatal mortality, neuroprotection
MeSH terms
Electroencephalography, Female, Humans, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases, Magnetic Resonance Imaging, Male, Multiple Organ Failure, Retrospective Studies, Hypoxia-Ischemia, Brain

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