Elevated Activin A urine levels are predictors of intraventricular haemorrhage in preterm newborns

Aim Intraventricular haemorrhage (IVH) is the most common variety of cerebral haemorrhage and cause of neurological disabilities in preterm newborns. We evaluated the usefulness of urine Activin A concentrations for the early detection of perinatal IVH. Methods We conducted a case-control study on 100 preterm newborns (20 with IVH and 80 without IVH) in whom urine Activin A was measured at five predetermined time-points in the first 72h after birth. IVH diagnosis and the extension of the lesion were performed by ultrasound scanning within the first 72h and at 1week after birth, respectively. Results Urine Activin A in infants who developed IVH was significantly higher than in controls at all monitoring time-points (p<0.01 for all), increasing progressively from first urination to 24h when it reached the highest peak (p<0.001). At a cut-off 0.08ng/L, at the first void, Activin A sensitivity and specificity were 68.7% (CI: 41.3-89%) and 84.5% (CI: 75-91.5%). Conclusion Activin A measurements in urine soon after birth can constitute a promising tool for identifying preterm infants at risk of IVH.