Background: Infants born before 30 weeks gestation are at an increased risk of adverse neurodevelopmental outcomes, including delayed cognitive, language and motor abilities. Identification of cord blood biomarkers that predict later child neurodevelopment may allow “at risk” children to be identified early, so resources can be directed to those most likely to benefit. Neurotrophins are a potential candidate, as they have multiple, critical roles in brain growth and development. The aim of this study was to identify associations between cord blood neurotrophin concentrations and neurodevelopmental outcomes during the first 3 years of life.
Methods: Cord blood was collected from very preterm infants (<30 weeks) at the Women’s and Children’s Hospital, Adelaide. Neurotrophins were measured by ELISA and standardised neurodevelopmental batteries were used to assess development at aged 12 months (n=32), 24 months (n=85) and 36 months (n=37).
Results: No correlations were observed between brain derived neurotrophic factor (BDNF), neurotrophic factor-3 (NT3) or neurotrophic factor-4 (NT4) and child scores on the cognitive, motor or language domains of the Griffiths Mental Development Scales conducted at 12 months of age, or the Bayley II Scale, at 24 and 36 months of age. At 24 months, however, a trend towards reduced cord blood NT3 was observed in those with delay in the cognitive (p=0.074), receptive language (p=0.074) and fine motor domains (p=0.054). A trend was also observed between increased BDNF and improved motor performance at 2 years (r=0.288, p=0.07).
Conclusion: Cord blood neurotrophin levels in isolation were not associated with child neurodevelopmental outcomes, however the trends observed suggest that they may be informative when paired with other clinical or demographic outcomes. The identification of combined clinical and biological measures to predict poor outcomes may allow interventions to be implemented early at a time when the brain is most plastic and receptive to change.