Aim Neonatal Hypoxic Ischemic Encephalopathy (HIE) diagnosis and prognosis are established through clinical evidence, laboratory, imaging, and electrophysiological assessment of the nervous system. Netrin-1 (NT-1) was the first axon guidance molecule identified as a critical component of embryonic development in vertebrates and has a solid chemotropic function for angiogenesis, morphogenesis, cell migration, and axonal guidance. We hypothesize that NT-1 will differ at different stages of HIE.

Material and Method The study included 75 newborns with HIE who were hospitalized and 28 healthy newborns born in the same hospital who were followed up only by their mothers. Demographic data, laboratory, and NT-1 were evaluated in all HIE stages.

Results Serum NT-1 concentrations obtained immediately after the diagnosis of HIE were significantly higher in patients with moderate and severe HIE who underwent therapeutic hypothermia than in controls and patients with severe HIE than in patients with moderate HIE, whereas they were not significantly higher in patients with mild HIE than in controls. In 75 HIE patients, the correlations of NT-1 with lactate, uric acid, and LDH were statistically significant (p=0.0001, p=0.008, p=0.043, respectively).

Conclusions NT-1 is significantly correlated with lactate, a crucial blood value for neonatal HIE, and both parameters are significantly increased in moderate and severe patients. Therefore, we reported that the marker could be a biomarker for staging HIE and therapeutic hypothermia and prognosis of neonatal HIE.