The term "
encephalopathy of prematurity" encompasses not only the
acute brain injury [such as intraventricular
hemorrhage (IVH)] but also complex disturbance on the infant's subsequent brain development. In premature infants, the most frequent recognized source of
brain injury is IVH and
periventricular leukomalacia (PVL). Furthermore 20-25% infants with birth weigh less than 1,500 g will have IVH and that proportion increases to 45% if the
birth weight is less than 500-750 g. In addition, nearly 60% of very low birth weight newborns will have hypoxic-ischemic injury. Therefore permanent lifetime neurodevelopmental disabilities are frequent in premature infants. Innovative approach to prevent or decrease
brain injury in preterm infants requires discovery of
biomarkers able to discriminate infants at risk for injury, monitor the progression of the injury, and assess efficacy of neuroprotective clinical trials. In this article, we will review
biomarkers studied in premature infants with IVH, Post-hemorrhagic ventricular dilation (PHVD), and PVL including: S100b,
Activin A,
erythropoietin,
chemokine CCL 18, GFAP, and NFL will also be examined. Some of the most promising
biomarkers for IVH are S100β and
Activin. The concentrations of TGF-β1, MMP-9, and
PAI-1 in cerebrospinal fluid could be used to discriminate patients that will require shunt after PHVD. Neonatal
brain injury is frequent in premature infants admitted to the
neonatal intensive care and we hope to contribute to the awareness and interest in clinical validation of established as well as novel neonatal
brain injury biomarkers.