Surgical Innovation Abstracts

Introduction: Early detection of hypoxic-ischaemic encephalopathy (HIE) in neonates is critical and may guide the need for surgical intervention.Current diagnostic methods may miss mild or delayed presentations as they do not assess neuronal injury directly.Measurement of cord blood neurofilament light (NfL), a neuronal injury biomarker, may improve diagnosis.To assess whether NfL should be investigated in trials of HIE, we aimed to first explore its association with short-term adverse neonatal outcomes.Methods: Prospective cohort study.Setting: A single, large tertiary referral centre in Australia.Patients: 109 maternal participants consenting to donate cord blood.Intervention: Umbilical cord venous blood plasma NfL levels.Main outcome measures: Demonstrate feasibility of NfL sample collection and analysis in an Australian cohort.(1) Association of NfL with fetal and maternal characteristics; (2) association of NfL with other cord biomarkers;(3) relationship of NfL to non-reassuring fetal status, NICU admission and length of stay.Results: Cord NfL was successfully analysed in 109/116 recruited participants, of 509 total possible participants.Cord NfL was higher in preterm neonates, and was correlated with cord lactate, pH, and base excess.Conclusions: Feasibility aspects of the study were successful, after discussing with ethics and governance, the inclusion of retrospective consent was explored as a strategy to increase recruitment capacity.Consumer engagement activities were completed to gage understanding and interest from the community (new mothers, pregnant women and their partners).Further engagement with midwives and neonatologists as stakeholders will solidify the success of further studies and innovation in this area.Cord blood NfL levels can be measured and used as a correlate of adverse outcomes in an Australian cohort.Higher venous cord blood NfL levels were associated with non-reassuring fetal status.Further research is needed to validate these findings and establish the role of NfL, if any, in clinical practice.