Could a protein predict risk of death, cerebral palsy in preterm babies?

A new research has revealed that preterm babies born without haptoglobin, a protein in blood cells; have higher odds of brain bleeding, cerebral palsy and death.

The study, published in the Journal of EClinicalMedicine, suggests that the absence of the protein could serve as a potential biomarker indicating a need for increased monitoring or other preventive interventions.

Dr Catalin Buhimschi and Dr Irina Buhimschi led the research and analysed cord blood samples from 921 newborns to see if haptoglobin was associated with poor outcomes in babies who had been exposed to in-utero inflammation, which causes about 30 per cent of preterm births.

By calculating odds ratios, a statistic indicating the strength or weakness of an association, they found that preterm babies who had been exposed to inflammation and who lacked haptoglobin were more likely to die before 1 year or develop cerebral palsy by 2 years when compared to preterm babies who had the protein or had not been exposed to inflammation.

Odds of intraventricular haemorrhage, known as bleeding in the brain, were also higher in this group.

These findings persisted even when potentially confounding factors, like birth weight, gestational age, foetal sex or other treatments, such as magnesium sulfate given for neuroprotection, were evaluated.

"Our study provides strong evidence that an absence of haptoglobin in preterm babies who have been exposed to inflammation is an indicator of increased risk for complications like brain bleeding, cerebral palsy and even death," said Dr Catalin Buhimschi, corresponding author.

"This underscores the potential protective role of haptoglobin against short- and long-term poor neonatal outcomes and suggests that the protein may be a valuable marker of neurologic damage and the need for clinical interventions," he added.

Catalin Buhimschi and Irina Buhimschi have conducted multiple studies on haptoglobin in preterm babies but this is the first study to include a large, representative sample of participants.

Irina Buhimschi, professor of obstetrics and gynaecology and study co-author, said that this individualised approach to understanding risk among a specific group of newborns is needed in the maternal-foetal medicine speciality.

"New mothers and babies are particularly complex and we cannot put all preterm deliveries under the same umbrella," Irina Buhimschi said.

For their studies, Catalin Buhimschi and Irina Buhimschi developed a new method of testing haptoglobin at very low levels, as the protein does not reach adult levels until babies are about one year old.

"The takeaway message of this study is that a simple test of cord blood after delivery could help doctors develop an individualised care plan for some at-risk newborns," said Catalin Buhimschi.