TY - JOUR
T1 - Vaginal Delivery Is Associated with Neurochemical Evidence of Increased Neuroaxonal Remodelling in Infants from the KUNO-Kids Health Study
T2 - Cross-Sectional Analysis
AU - Kürner, Katja
AU - Goeral, Katharina
AU - Atkinson, Andrew
AU - Brandstetter, Susanne
AU - Toncheva, Antoaneta A.
AU - Kabesch, Michael
AU - Apfelbacher, Christian
AU - Melter, Michael
AU - Seelbach-Göbel, Birgit
AU - Berger, Angelika
AU - Kuhle, Jens
AU - Wellmann, Sven
N1 - Publisher Copyright:
© 2022
PY - 2022/12/1
Y1 - 2022/12/1
N2 - 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.
AB - 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.
KW - Biomarker
KW - Birth mode
KW - Central nervous system
KW - Neuron
KW - Serum
UR - https://www.scopus.com/pages/publications/85140216829
U2 - 10.1159/000526472
DO - 10.1159/000526472
M3 - Article
C2 - 36108619
AN - SCOPUS:85140216829
SN - 1661-7800
VL - 119
SP - 769
EP - 776
JO - Neonatology
JF - Neonatology
IS - 6
ER -