Abstract
Serum creatine kinase BB-isoenzyme (CK-BB) activity was studied on the first day of life in 31 acutely asphyxiated infants, 70 infants born after high risk pregnancies (pre-eclampsia or intrauterine growth retardation, or both), and 47 very low birthweight infants. Neuro-developmental evaluation was carried out at 2.2-2.5 years. Eight infants died with, and eight without, hypoxic-ischaemic lesions of the brain, 14 had cerebral palsy, 16 had mild motor impairment, six had developmental delay without motor impairment, and 96 were normal at follow up. Infants who died with brain injury had significantly higher CK-BB activity than infants with normal outcomes (geometric mean 12 U/l); the mean difference was 82 U/l with a 95% confidence interval from 31 to 219 U/l. CK-BB in infants with cerebral palsy and mild motor impairment (geometric means 12 and 15 U/l, respectively) were similar to controls. CK-BB activity after birth is predictive of neonatal death but not of neurological damage in survivors.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Becker M., Menzel K. Brain-typical creatinekinase in the serum of newborn infants with perinatal brain damage. Acta Paediatr Scand. 1978 Mar;67(2):177–180. doi: 10.1111/j.1651-2227.1978.tb16299.x. [DOI] [PubMed] [Google Scholar]
- Cuestas R. A., Jr Creatine kinase isoenzymes in high-risk infants. Pediatr Res. 1980 Aug;14(8):935–938. doi: 10.1203/00006450-198008000-00008. [DOI] [PubMed] [Google Scholar]
- Ezitis J., Finnström O., Hedman G., Rabow L. CKBB-enzyme activity in serum in neonates born after vaginal delivery and cesarean section. Neuropediatrics. 1987 Aug;18(3):146–148. doi: 10.1055/s-2008-1052467. [DOI] [PubMed] [Google Scholar]
- Fenichel G. M. Hypoxic-ischemic encephalopathy in the newborn. Arch Neurol. 1983 May;40(5):261–266. doi: 10.1001/archneur.1983.04050050029002. [DOI] [PubMed] [Google Scholar]
- Fernández F., Verdú A., Quero J., Pérez-Higueras A. Serum CPK-BB isoenzyme in the assessment of brain damage in asphyctic term infants. Acta Paediatr Scand. 1987 Nov;76(6):914–918. doi: 10.1111/j.1651-2227.1987.tb17263.x. [DOI] [PubMed] [Google Scholar]
- Hagberg B., Hagberg G., Olow I. The changing panorama of cerebral palsy in Sweden. IV. Epidemiological trends 1959-78. Acta Paediatr Scand. 1984 Jul;73(4):433–440. doi: 10.1111/j.1651-2227.1984.tb09951.x. [DOI] [PubMed] [Google Scholar]
- Hagberg G., Hagberg G., Olow I. The changing panorama of cerebral palsy in Sweden 1954-1970. II. Analysis of the various syndromes. Acta Paediatr Scand. 1975 Mar;64(2):193–200. doi: 10.1111/j.1651-2227.1975.tb03821.x. [DOI] [PubMed] [Google Scholar]
- Hans P., Born J. D., Chapelle J. P., Milbouw G. Creatine kinase isoenzymes in severe head injury. J Neurosurg. 1983 May;58(5):689–692. doi: 10.3171/jns.1983.58.5.0689. [DOI] [PubMed] [Google Scholar]
- Hørder M., Magid E., Pitkänen E., Härkönen M., Strömme J. H., Theodorsen L., Gerhardt W., Waldenström J. Recommended method for the determination of creatine kinase in blood modified by the inclusion of EDTA. The Committee on Enzymes of the Scandinavian Society for Clinical Chemistry and Clinical Physiology (SCE). Scand J Clin Lab Invest. 1979 Feb;39(1):1–5. doi: 10.3109/00365517909104932. [DOI] [PubMed] [Google Scholar]
- Jedeikin R., Makela S. K., Shennan A. T., Rowe R. D., Ellis G. Creatine kinase isoenzymes in serum from cord blood and the blood of healthy full-term infants during the first three postnatal days. Clin Chem. 1982 Feb;28(2):317–322. [PubMed] [Google Scholar]
- Kaste M., Somer H., Konttinen A. Brain-type creatine kinase isoenzyme. Occurrence in serum in acute cerebral disorders. Arch Neurol. 1977 Mar;34(3):142–144. doi: 10.1001/archneur.1977.00500150028004. [DOI] [PubMed] [Google Scholar]
- Kumpel B., Wood S. M., Anthony P. P., Brimblecombe F. S. Umbilical cord serum creatine kinase BB in the diagnosis of brain damage in the newborn: problems in interpretation. Arch Dis Child. 1983 May;58(5):382–383. doi: 10.1136/adc.58.5.382. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nelson K. B., Ellenberg J. H. Apgar scores as predictors of chronic neurologic disability. Pediatrics. 1981 Jul;68(1):36–44. [PubMed] [Google Scholar]
- Powell T. G., Pharoah P. O., Cooke R. W. Survival and morbidity in a geographically defined population of low birthweight infants. Lancet. 1986 Mar 8;1(8480):539–543. doi: 10.1016/s0140-6736(86)90893-7. [DOI] [PubMed] [Google Scholar]
- Ruth V. J., Raivio K. O. Perinatal brain damage: predictive value of metabolic acidosis and the Apgar score. BMJ. 1988 Jul 2;297(6640):24–27. doi: 10.1136/bmj.297.6640.24. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ruth V., Autti-Rämö I., Granström M. L., Korkman M., Raivio K. O. Prediction of perinatal brain damage by cord plasma vasopressin, erythropoietin, and hypoxanthine values. J Pediatr. 1988 Nov;113(5):880–885. doi: 10.1016/s0022-3476(88)80024-6. [DOI] [PubMed] [Google Scholar]
- Shields W. D., Feldman R. C. Serum CK-BB isoenzyme in preterm infants with periventricular hemorrhage. J Pediatr. 1982 Mar;100(3):464–468. doi: 10.1016/s0022-3476(82)80461-7. [DOI] [PubMed] [Google Scholar]
- Walsh P., Jedeikin R., Ellis G., Primhak R., Makela S. K. Assessment of neurologic outcome in asphyxiated term infants by use of serial CK-BB isoenzyme measurement. J Pediatr. 1982 Dec;101(6):988–992. doi: 10.1016/s0022-3476(82)80027-9. [DOI] [PubMed] [Google Scholar]