Neuron-specific enolase in cerebrospinal fluid predicts brain injury after sudden unexpected postnatal collapse

Abstract Introduction Biomarkers of brain injury with high predictive value in newborns in critical neurological status are increasingly required. Neuron-specific enolase in cerebrospinal fluid (CSF-NSE) has been shown to be highly predictive in newborns with perinatal hypoxic-ischemic encephalopathy (HIE), but its utility has not been examined in Sudden Unexpected Postnatal Collapse (SUPC). Purpose To determine if the levels of CSF-NSE can be a useful biomarker to estimate the severity of the brain injury in neonates after an SUPC. Methods Prospective observational study of near-term infants who were consecutively admitted with SUPC in two neonatal intensive care units during a 9-year period. Variables were collected and analyzed regarding the perinatal period, clinical course, severity of encephalopathy, amplitude-integrated encephalography (aEEG), MRI findings, and outcome. CSF-NSE samples were obtained in 18 infants with SUPC between 12 and 72 hours after the collapse, and compared with 29 controls. Results CSF-NSE levels were higher in patients than in controls (p Conclusion CSF-NSE levels obtained between 12 and 72 hours after an SUPC event seem to be a useful biomarker for identifying newborns with severe brain injury and for predicting outcome.