The importance of markers of osteolysis and osteogenesis in the pathogenesis of cephalohematoma in newborns

Background. Of particular importance in the repair process for cephalohematomas is the pathological remodeling of the bones of the cranial vault. Local changes in the bones of the skull are accompanied by the processes of osteolysis and osteogenesis and have uncertain dynamics. Changes in the state of bone tissue in cephalohematomas can be monitored based on determining the concentration of markers of osteolysis and osteogenesis in the blood of newborns.

The  aim. To  define the  level of  markers of  osteolysis (beta-CrossLaps) and osteogenesis (N-osteocalcin, vascular endothelial growth factor receptor 1 (VEGFR1)) in  the  venous blood serum of  newborns with cephalohematomas and evaluate the dynamics of local bone changes.

Methods. There were 90 newborns under observation, 30 patients with medium and large cephalohematomas (the cephalohematoma was punctured), 30 patients with small cephalohematomas (the puncture was not performed) and 30 healthy children. The level of markers of osteolysis and osteogenesis in the blood was determined by photometry using an enzyme-linked immunosorbent assay. Registration of local bone changes was carried out using ultrasonography and craniometry.

Results. The level of beta-CrossLaps in patients from the first group was 2.57 times higher, and in patients from the second group 4.45 times higher, than in healthy newborns on day 10 (p < 0.001). The concentration of N-Osteocalcin on day 10 in the second group was 1.43 times higher than in the first group (p < 0.001). The concentration of VEGFR1 in patients from the first group was 1.9 times higher, and in patients from the second group 3.01 times higher than in the control group (p < 0.001). Local osteolytic changes in the skull predominated in patients of the first group on day 10, and ossification in the second group on day 28 of observation (p < 0.001).

Conclusion. Reparation for cephalohematomas is associated with the phenomena of  resorption of  the  bones of  the  cranial vault and pathological ossification of hemorrhage in the zone of periosteum separation. Changes in the level of markers of osteogenesis and osteolysis in venous blood serum in patients with cephalohematomas may reflect the dynamics and direction of the pathophysiological process of remodeling of the bones of the cranial vault.

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