Neonatal brain injury (NBI) has a heterogenous aetiology with a high economic and social burden. Neonatal encephalopathy describes the babies who require resuscitation at birth and have an abnormal neurological examination. It remains difficult to predict their developmental outcome. Enhanced inflammatory responses are seen in affected infants and correlate with outcomes. Multiorgan dysfunction is common with renal, hepatic, cardiac and haematological abnormalities.We aim to correlate these inflammatory responses with clinical, neurodevelopmental and MRI outcomes to establish biomarkers of brain injury in neonates. Our translational research group includes laboratory scientists and clinicians to evaluate both inflammatory responses and correlate with multiple organ dysfunction. We have incorporated newer modalities for cardiac function (echo speckle tracking, troponin and BNP), brain imaging (EEG, MRI and fMRI), renal biomarkers (eg.NGAL, cystatin c), placental pathology and haematological indices. This research may allow early recognition of brain injury prior to MRI (Day 5-7) so that new therapies as adjuvants to therapeutic hypothermia can be initiated as soon as possible after birth.Developing clinically useful early biomarkers incorporating clinical outcomes are crucial in this group. Although neurological outcomes are evaluated in the short-term in this patient group there is no assessment of longterm cardiac, renal, immune and haematological status and we aim to coordinate followup of these parameters until at 2 years of age.
