Plasma platelet-activating factor levels in newborn infants with and without perinatal asphyxia: Is it an additional marker of perinatal asphyxia?

Background: Hypoxic-ischemic encephalopathy (HIE) is still a very important cause of neonatal mortality and morbidity. Recently platelet-activating factor (PAF) has been accused of being responsible for the neuronal damage in hypoxic-ischemic brain. Methods: Therefore, we conducted a study in newborns with perinatal asphyxia to try to show the relationship between the clinical severity and plasma PAF levels. Results: Mean plasma levels of 19 asphyxiated infants (997.8 +/- 363.5 pg/mL) were significantly higher than that of 20 healthy infants (410.2 +/- 148.6 pg/mL, P < 0.0001). Patients with clinically severe HIE had significantly higher levels of PAF (1491.2 +/- 386.6 pg/mL) when compared with patients with mild HIE (815 +/- 114.5 pg/mL) and with moderate HIE (828.3 +/- 61.1 pg/mL). There was a significant correlation between plasma PAF concentration and arterial pH and base deficit, but no correlation with platelet and leukocyte counts. Conclusions: Plasma PAF levels correlating with the severity of HIE is interpreted to mean that high PAF levels may be an indicator of clinical severity and probably the poorer prognosis of patients with HIE.