Evaluation of Chemokine CCL18 Level in Cord and Peripheral Blood as a Predictor of Intraventricular Hemorrhage in Preterm Infants

Document Type : Original Article

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Abstract

Background: Intraventricular hemorrhage (IVH) is a serious complication of prematurity. While early diagnosis is crucial for appropriate management, determining high-risk neonates might prompt extra preventive measures. Low levels of Chemokine (C-C motif) ligand 18 (CCL18) may predict the development of IVH in preterms.
Aim of the study: to evaluate the association between CCL18 level in cord and peripheral blood and the incidence of IVH in preterm neonates. Patients and methods:This prospective cohort study included, 51 preterm neonates aged (29-32 weeks). Neonates with perinatal hypoxia, brain malformations, or major congenital malformations were excluded. CCL18 was analyzed in cord blood at birth and in the peripheral blood on day 2 of life. Cranial ultrasound scans were done on day 3 and day 7.
Results: Out of the studied neonates, only 44 were enrolled,18 males (40.9%) and 26 females (59.1%). The incidence of IVH was 52.3% (23/44). No statistical differences were observed in gestational age (p=0.59), weight (p=0.192), gender (p=0.139), maternal illness (p=0.355), and Apgar score (p=0.961) in both groups. Cord and blood CCL18 were comparable in patients with and without IVH (p=0.518 & p=0.70 respectively). Impaired neurological examination and low platelet count were significantly associated with IVH (p < 0.05).
Conclusion: The current work suggests that the CCL18 level in the cord or peripheral blood can’t indicate preterm neonates at a higher risk of developing IVH. Through neurological examination, sequential cranial ultrasounds and platelet counts might be a more convenient tool for early detection of IVH in preterm babies.
 

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