The association of umbilical cord blood neurofilament light with non‐reassuring fetal status: A prospective observational study
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: Early detection of hypoxic-ischemic encephalopathy (HIE) in neonates is critical. We conducted a pilot cohort study to determine the feasibility of collecting umbilical cord blood samples for neurofilament light (NfL) and to assess the association of NfL with non-reassuring fetal status and other cord biomarkers. We aimed to address (1) Feasibility of cord NfL sample collection and analysis; (2) Association of NfL with non-reassuring fetal status (CTG changes and/or documented non-reassuring fetal status), neonatal intensive care unit (NICU) admission and length of stay; (3) Correlation of NfL with other cord biomarkers. METHODS: This was a prospective cohort study performed in a single, large tertiary and quaternary referral hospital. A total of 108 maternal participants consented to donate cord blood. Umbilical cord blood NfL levels were measured via single molecule array (Simoa) analysis. RESULTS: Cord NfL was higher in preterm neonates and was correlated with cord lactate, pH, and base excess. After controlling for mode of delivery and gestational age, NfL (odds ratio [OR] = 2.29, 95% confidence interval [CI]: 1.15-5.57), but not pH (OR = 0.78, 95% CI: 0.42-1.41), base excess (OR = 0.83, 95% CI: 0.37-1.86), or lactate (OR = 1.06, 95% CI: 0.51-2.12) was associated with non-reassuring fetal status. NfL levels were higher in neonates admitted to NICU (median [IQR]: 11.3 [7] vs 8.5 [5.1]). CONCLUSION: Cord blood NfL analysis was feasible and provided correlates of adverse outcomes. Higher venous cord blood NfL levels were associated with non-reassuring fetal status. Further research is needed to validate these findings and establish the role of NfL, if any, in clinical practice.
Authors: David Zalcberg, Kaitlin Kramer, Emma Payne, Thomas Payne, Shreeya Marathe, Neha Mahajan, Ashly Liu, Jessica Barry, Andrew Duckworth, Mitchell Brooks, Bradley de Vries, Fernando Gonzalez‐Ortiz, Kaj Blennow, Henrik Zetterberg, Adrienne Gordon, Benjamin Moran, Helen J. Manning, Robert D. Sanders
Institutions: The University of Sydney, Royal Prince Alfred Hospital, Sydney Local Health District, St George Hospital, South Eastern Sydney Local Health District, The Royal Melbourne Hospital, National Health and Medical Research Council, Sahlgrenska University Hospital, University of Gothenburg, University of Science and Technology of China, Sorbonne Université, Institut des Sciences Moléculaires, Pitié-Salpêtrière Hospital, Institut du Cerveau, University of Wisconsin System, University of Wisconsin–Madison, UK Dementia Research Institute, UCL Queen Square Institute of Neurology, University College London, Gosford Hospital, The George Institute for Global Health, University of Newcastle Australia, Central Coast Local Health District
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,480
Funders: Alzheimer's Association, Alzheimer's Drug Discovery Foundation, Familjen Erling-Perssons Stiftelse, Cure Alzheimer's Fund, Stiftelsen för Gamla Tjänarinnor, EU Joint Programme – Neurodegenerative Disease Research, National Institute for Health and Care Research, University College London, European Commission, Hjärnfonden, Vetenskapsrådet, UK Dementia Research Institute, Fondation pour la Recherche sur Alzheimer, HORIZON EUROPE Framework Programme
Awards: G1057200632, G1088883541, G1135383168, G1222782219, G1253720191, G1311708188, G1373393710, The Alzheimer’s Association quality control (QC) program for CSF and plasma biomarkers - Continuation, G150733400, G1551449788, G1588116593, G1771944843, G1802301745, G1833008592, Understanding Alzheimer Blood Biomarkers for Tau Pathology, G201353144, G2057385626, G2108271864, G237833635, G2385484910, G2501682398, G2543812357, G2799940023, The Alzheimer biomarker toolbox – use in pathogenic studies, diagnostics and theragnostics, G2841269746, G2879339865, G292763017, G3027168043, G308275008, G313301595, G3241251457, Fluid biomarkers for neurodegenerative dementias, G3903502641, G3914690605, G4181470480, G4234328627, G4260843567, G432431387, G434337789, G4377393254, G4404751248, G5040492720, G506008078, G516766298, Tau pathology in Alzheimer´s - understanding pathophysiology through biomarkers in blood and CSF, Fluid biomarkers for neurodegenerative dementias, G5619554209, CASCADE: CAuSe or Consequence in Alzheimer DiseasE?, G6142763750, G6158734006, G6168044258, G6289970089, Multi-omics Interdisciplinary Research Integration to Address DEmentia diagnosis, G6745400708, G691317373, G7143958211, G7748812462, G791739130
OpenAlex ID: W4413766720