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Arch Dis Child Fetal Neonatal Ed 2001;84:F49-F52 ( January )

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.
METHODS---A 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.
RESULTS---Infants 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.
CONCLUSIONS---Elevated 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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[Abstract] [Full Text] [PDF]


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