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Background. Hypoxic ischemic encephalopathy (HIE) is a major cause of neurological disabilities in infants. Several possible early biomarkers for hypoxic injury have been investigated but none of them have been completely utilized in clinical practice. Serum S100b is one such early biomarker. Objective. The above study aims to assess the usefulness of the biomarker S100b in predicting the severity as well as the outcome of neonates having HIE. Materials and methods. A prospective cohort study was done on 80 term newborns admitted to the neonatal intensive care unit (NICU), Institute of medical sciences & SUM hospital, Bhubaneswar from August 2019 to February 2021. Out of the total 80 term newborns, 20 newborns without any evidence of perinatal hypoxia were categorized as the Controls, and the rest of 60 newborns with perinatal hypoxia were categorized as Cases. Cases were further divided into 3 subgroups based on Sarnat and Sarnat staging with 27 newborns in HIE I, 17 newborns in HIE II, and 16 newborns in HIE III. Serum S100b was measured in all the above children at 4 and 48 hours of life. Result. In our study, the mean serum S100b level at 4h & 48h of life was 1.15 & 1.05 respectively in controls and 3.24 & 2.36 (p<o.oo1) respectively in cases. The mean S100b level in subgroup HIE I, II, III were 2.06, 2.79 & 5.12 at 4h of life and 1.35, 1.86 & 4.08 at 48h of life, which is gradually increasing with the severity of asphyxia. On follow-up, it was found that babies with high S100b at 4h & 48 h of birth had more neurological sequelae. ROC curve depicted area under the curve was 0.80 showing high predictability of S100b for the neurological outcome. It was also seen that the cut-off value of 3.09 at 4 h has a sensitivity of 80% and specificity of 78.2%. Conclusion. Serum S100b is not only an early biomarker for HIE but also helps in prognostication, which is an essential part of the treatment of newborns and during the counseling of parents.
Reddy et al. (Sun,) studied this question.