{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:34:27Z","timestamp":1787027667345,"version":"build-2736575974"},"reference-count":40,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,9,20]],"date-time":"2021-09-20T00:00:00Z","timestamp":1632096000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Special Account for Research Grants","award":["019773\/2020"],"award-info":[{"award-number":["019773\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Disruption of normal intrauterine brain development is a significant consequence of premature birth and may lead to serious complications, such as neonatal brain injury (NBI). This prospective case-control longitudinal study aimed at determining the levels and prognostic value of serum activin A during the first three days of life in human premature neonates which later developed NBI. It was conducted in a single tertiary hospital and eligible participants were live-born premature (&lt;34 weeks) neonates. Each case (n = 29) developed NBI in the form of an intraventricular haemorrhage, or periventricular leukomalacia, and was matched according to birth weight and gestational age to one neonate with normal head ultrasound scans. Serum activin A levels in both groups showed a stable concentration during the first three days of life as no difference was observed within the two groups from the first to the third day. Neonates diagnosed with NBI had significantly higher activin A levels during the first two days of life compared to control neonates and its levels correlated to the severity of NBI during the second and third day of life. Although serum activin A on the second day was the best predictor for neonates at risk to develop NBI, the overall predictive value was marginally fair (area under the ROC-curve 69.2%). Activin A, in combination with other biomarkers, may provide the first clinically useful panel for the early detection of premature neonates at high risk of NBI.<\/jats:p>","DOI":"10.3390\/brainsci11091243","type":"journal-article","created":{"date-parts":[[2021,9,20]],"date-time":"2021-09-20T07:52:14Z","timestamp":1632124334000},"page":"1243","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Serum Activin A as Brain Injury Biomarker in the First Three Days of Life. A Prospective Case\u2014Control Longitudinal Study in Human Premature Neonates"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1788-3818","authenticated-orcid":false,"given":"Dimitra","family":"Metallinou","sequence":"first","affiliation":[{"name":"Department of Midwifery, University of West Attica, Ag. Spyridonos Street, 12243 Egaleo, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5897-8958","authenticated-orcid":false,"given":"Grigorios","family":"Karampas","sequence":"additional","affiliation":[{"name":"2nd Department of Obstetrics and Gynecology, Aretaieio University Hospital, 46 Vasilissis Sofias Avenue, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleftheria","family":"Lazarou","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Iasis Private Hospital Paphos, 8 Voriou Ipirou Street, 8036 Paphos, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikoletta","family":"Iacovidou","sequence":"additional","affiliation":[{"name":"Neonatal Department, Aretaieio University Hospital, 46 Vasilissis Sofias Avenue, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6593-6489","authenticated-orcid":false,"given":"Panagiota","family":"Pervanidou","sequence":"additional","affiliation":[{"name":"Unit of Developmental and Behavioral Pediatrics, 1st Department of Pediatrics, National and Kapodistrian University of Athens, 5 Mikras Asias Street, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Lykeridou","sequence":"additional","affiliation":[{"name":"Department of Midwifery, University of West Attica, Ag. Spyridonos Street, 12243 Egaleo, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Mastorakos","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, Diabetes Mellitus and Metabolism, Aretaieio University Hospital, 46 Vasilissis Sofias Avenue, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2143-3377","authenticated-orcid":false,"given":"Demetrios","family":"Rizos","sequence":"additional","affiliation":[{"name":"Hormone Laboratory, Aretaieio University Hospital, 46 Vasilissis Sofias Avenue, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,20]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Neonatal periventricular leukomalacia: Current perspectives","volume":"8","author":"Ahya","year":"2018","journal-title":"Res. Rep. 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