Predictive Value of Serum Amyloid A Protein in Newborn Infants with Hypoxic Ischemic Encephalopathy

Objective: Hypoxic-Ischemic Encephalopathy (HIE), remains a serious condition, causing significant mortality and long-term morbidity. In spite of major advances in monitoring technology and knowledge of fetal and neonatal pathologies perinatal asphyxia remains a major concern. Serum Amyloid A (SAA) is an acute phase inflammatory marker that is closely associated with ischemic injuries.This study was aimed to evaluate the serum level of SAA in neonatal HIE and its concentration correlates with the severity of encephalopathy.Study Design: We conducted a prospective case- control study on 44 full-term neonates; 24 cases with evidence of perinatal compromise and 20 healthy controls. Blood samples were collected from cases and controls at postnatal day 1 and day 7, and SAA was measured by ELISA.Results: SAA concentrations (mgml-1) were significantly increased in cases when compared with controls at day 1 and at day 7 (p 0.001). SAA concentrations at day 1 were greater in cases who died when compared with those who survived, and correlated significantly with the severity of HIE (163.2± 62.4, 86.8±30.4, 54.2±17.3) in severe, moderate and mild HIE, respectively (p=0.001).Conclusions: The level of SAA is increased in response to hypoxic ischemia of the neonate. The increased concentration correlates with the severity of encephalopathy and is associated with mortality.