Objective To investigate the early predictive value of cord blood S100β protein and lactate combined with the modified Kidokoro magnetic resonance imaging (MRI) score (the modified Kidokoro score) for neurodevelopmental disorders at 6 months of corrected age in moderate and late preterm infants. Methods A retrospective analysis was conducted on the clinical data of 127 moderate-to-late preterm infants admitted to Jinjiang Municipal Hospital between January 2024 and January 2025. Using the Neuropsychological Developmental Scale for Children Aged 0 - 6 Years, infants were assessed at corrected age of 6 months and categorized into neurodevelopmental disorder group (n=16) and normal neurodevelopment group (n=111). Clinical data, cord blood S100β protein and lactate levels of the preterm infants were collected. Cranial MRI was performed 7 - 14 days after birth, and brain abnormalities were quantitatively evaluated using the modified Kidokoro scoring system. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive performance of individual and combined biomarker testing for brain injury in mid-to-late term preterm infants. Results The levels of umbilical cord blood S100β protein (t=2.732) and lactate (t=2.576), as well as the modified Kidokoro scores (t=7.531), were significantly higher in the neurodevelopmental disorder group than in the normal group (P<0.05). ROC curve analysis showed that the areas under the curve (AUC) of cord blood S100β protein, lactate and the modified Kidokoro score alone for predicting neurodevelopmental disorders were 0.719 (95%CI: 0.569 - 0.870), 0.686 (95%CI: 0.547 - 0.825) and 0.918 (95%CI: 0.830 - 1.000), respectively. Among the machine learning algorithms, the artificial neural network (ANN) model, combining gestational age, lactate, S100β and the modified Kidokoro score, demonstrated the optimal predictive performance, with an AUC of 0.937, accuracy of 0.962, sensitivity of 0.850, and specificity of 0.982. Conclusion The combination of umbilical cord blood S100β protein, lactate, and the modified Kidokoro score effectively improves the early prediction of neurodevelopmental disorders in moderate-to-late preterm infants, which may provide reliable laboratory and imaging basis for early clinical intervention.
Key words
moderate and late preterm infants /
neurodevelopmental disorders /
S100β protein /
lactate /
modified Kidokoro magnetic resonance score /
early prediction
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