Neonatal catecholamine levels and neurodevelopmental outcome: a cohort study
D J Evans, R J MacGregor, H G Dean, M I Levene
Centre for
Reproduction, Growth and Development, University of Leeds, D Floor
Clarendon Wing, General Infirmary at Leeds, Leeds LS2 9NS, UK
Correspondence to: Dr Evans, Neonatal Intensive Care Unit, Southmead Hospital, Bristol BS10 5NB, UK evans_d{at}southmead.swest.nhs.uk
Accepted 4 September
2000
AIMS
To determine
whether neonatal plasma catecholamine concentrations can be used to
predict (a) death plus disability and
(b) motor and cognitive impairment at 5 years of age.
METHODSA cohort
comprised 136 preterm infants from two randomised controlled trials of
neonatal sedation (1989-1992). Adrenaline (epinephrine) and
noradrenaline (norepinephrine) were measured at baseline (first day)
and 24 hours later. Intelligence and motor ability were assessed at
5-6 years.
RESULTSInfants who
died or sustained disability had significantly higher plasma
noradrenaline levels on the second day of life. Noradrenaline levels
above 9.0 nmol/l were most predictive of death (likelihood ratio 3.27;
95% confidence interval 1.48 to 7.23) and death plus disability
(likelihood ratio 3.55; 95% confidence interval 1.77 to 7.10). There
was no correlation between neonatal catecholamine levels and cognitive
or motor impairment at 5-6 years.
CONCLUSIONSElevated
noradrenaline levels are associated with adverse outcome in preterm
infants; however, the power to predict death or disability is limited
and they are not predictive of later motor or cognitive impairment.
Keywords: adrenaline; noradrenaline; catecholamines; intelligence; motor function; predictive ability
© 2001 by Archives of Disease in Childhood
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