Am J Perinatol 2020; 37(07): 722-730
DOI: 10.1055/s-0039-1688818
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effect of Hypothermia and Severity of Hypoxic-Ischemic Encephalopathy in the Levels of C-Reactive Protein during the First 120 Hours of Life

Amaia Cilla
1  Department of Pediatrics, Burgos University Hospital, Burgos, Spain
,
Juan Arnaez
2  Neonatology Unit, Burgos University Hospital, Burgos, Spain
3  NeNe Foundation, Spain
,
Isabel Benavente-Fernández
3  NeNe Foundation, Spain
4  Neonatology Unit, Puerta Del Mar University Hospital, Cádiz, Spain
,
Carlos Ochoa
5  Department of Pediatrics, Virgen De La Concha Hospital, Zamora, Spain
,
Cristina Vega
2  Neonatology Unit, Burgos University Hospital, Burgos, Spain
,
Simón Lubián-López
3  NeNe Foundation, Spain
4  Neonatology Unit, Puerta Del Mar University Hospital, Cádiz, Spain
,
Alfredo Garcia-Alix
3  NeNe Foundation, Spain
6  Institut de Recerca Pediatrica Sant Joan de Dèu, Sant Joan de Dèu Hospital, Barcelona, Spain
7  Universitat de Barcelona, Barcelona, Spain
8  CIBER of Rare Diseases (CIBERER), Madrid, Spain
› Author Affiliations
Further Information

Publication History

08 August 2018

30 March 2019

Publication Date:
23 May 2019 (online)

Abstract

Objective This study aimed to describe normal C-reactive protein (CRP) levels of newborns diagnosed with hypoxic-ischemic encephalopathy (HIE) and assess the influence of therapeutic hypothermia (TH) and the severity of HIE.

Study Design We prospectively recruited infants ≥35 weeks of gestational age diagnosed with HIE from 2000 to 2013 and compared CRP levels in the first 120 hours of life according to the severity of HIE and the use of TH, which was introduced in 2009.

Results Moderate HIE was diagnosed in 115 newborns, severe HIE in 90 (hypothermia was performed in 151 cases), and mild HIE in 20. Cooled newborns showed lower levels of CRP in the first 34 hours, but reached higher median maximum CRP levels (15.4 vs. 8.5 mg/L), and at a significantly older age (53 vs. 17 hours). Levels of CRP in mild HIE were lower than those of moderate–severe forms. Moderate and severe HIE had similar CRP levels, but time to maximum CRP was significantly less in moderate cases.

Conclusion CRP levels of mild HIE are similar to healthy newborns, while CRP elevations can be expected in newborns with moderate–severe HIE. TH produced a slower rise, with a higher and late maximum CRP peak level.