Effect of therapeutic hypothermia on DNA damage and neurodevelopmental outcome among term neonates with perinatal asphyxia: a randomized controlled trial

J Trop Pediatr. 2014 Apr;60(2):134-40. doi: 10.1093/tropej/fmt098. Epub 2013 Dec 16.

Abstract

Objective: To study the effect of therapeutic hypothermia (TH) on deoxyribonucleic acid (DNA) damage and the neurodevelopmental outcome in term babies with perinatal asphyxia.

Methods: Babies in the hypothermia group were cooled for the first 72 h, using gel packs. Rectal temperature of 33-34°C was maintained. Blood sample was collected before, at 36 h and after completion of TH for assessment of comet assay and 8-hydroxy2-deoxyguanosine (8-OHdG). Infants were followed up till 12 months.

Results: Baseline parameters were similar. After 72 h, the hypothermia group showed lower olive tail moment (12.88 ± 2.14) than the control group (22.16 ± 5.26) (p < 0.001). 8-HDG levels increased significantly in the control group (1252.87 ± 357.07) as compared to the hypothermia group (757.03 ± 198.49) (p < 0.001). Neurodevelopmental assessment at 12 months showed significantly low motor and mental developmental quotient in the control than hypothermia group.

Conclusions: TH reduces oxidative stress-induced DNA damage and improves neurodevelopmental outcome. <Trial registration No: CTRI/2011/10/002094>

Keywords: comet assay; gel packs; neurodevelopment; oxidative stress; perinatal asphyxia; therapeutic hypothermia.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Asphyxia Neonatorum / complications
  • Asphyxia Neonatorum / therapy*
  • Comet Assay
  • DNA Damage*
  • Deoxyguanosine
  • Developmental Disabilities / etiology*
  • Developmental Disabilities / prevention & control
  • Female
  • Follow-Up Studies
  • Hospitals, Teaching
  • Humans
  • Hypothermia, Induced / adverse effects
  • Hypothermia, Induced / methods*
  • Hypoxia-Ischemia, Brain / complications
  • Hypoxia-Ischemia, Brain / therapy*
  • India
  • Infant
  • Infant, Newborn
  • Male
  • Oxidative Stress / physiology*
  • Severity of Illness Index
  • Single-Blind Method
  • Treatment Outcome

Substances

  • Deoxyguanosine