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Published on: June 24, 2020
Amniotic fluid inflammatory proteins and digestive compounds profile in fetuses with gastroschisis undergoing
Laurence Burc1, Jean-Luc Volumenie, Pascal de Lagausie
1Department of Perinatology, Hôpital Robert Debré, Paris, France.
Insights
Elevated amniotic fluid total proteins and ferritin in gastroschisis may indicate inflammation caused by digestive compounds. These levels correlate with short-term infant outcomes, suggesting their use as predictive markers.
Area of Science:
- Perinatology
- Fetal Medicine
- Biochemistry
Background:
- Gastroschisis involves intestinal damage potentially linked to amniotic fluid inflammation.
- Digestive compounds in amniotic fluid may trigger inflammatory processes.
Purpose of the Study:
- To measure amniotic fluid concentrations of total protein, ferritin, and digestive compounds (amylase, lipase, gamma-glutamyl transferase, bile acids) in gastroschisis.
- To assess the correlation between these markers and infant postnatal outcomes.
Main Methods:
- Amniotic fluid was sampled from 30 pregnant women with gastroschisis during amnioexchange procedures.
- Concentrations of total proteins, ferritin, and digestive compounds were measured and compared to controls.
- Infant outcomes and gestational age at delivery were recorded and correlated with amniotic fluid analytes.
Main Results:
- Positive correlations were found between digestive compounds and ferritin, and between digestive compounds and total proteins.
- Elevated lipase concentrations correlated with parameters of short-term infant outcomes (P < 0.05).
Conclusions:
- Amniotic fluid total proteins and ferritin are elevated in gastroschisis, likely due to inflammation.
- Inflammation may be induced by digestive compounds, whose concentrations could serve as markers for short-term infant outcomes.
Objective:
In gastroschisis, an inflammatory process related to the presence of digestive compounds may be involved in intestinal damage. We measured the amniotic fluid concentrations of total protein, ferritin and amylase, lipase, gamma-glutamyl transferase and bile acids before each amnioexchange performed in women whose infants had gastroschisis. We estimated the correlation among total proteins, ferritin and digestive compounds and postnatal outcome.
Design:
All women whose infants had gastroschisis in our fetal medicine unit are offered repeated amnioexchange during the third trimester of pregnancy to improve the quality of the exteriorised bowel at birth. Amniotic fluid was sampled at the beginning of each amnioexchange and total proteins, ferritin and digestive compounds were assayed.
Setting:
This study was conducted in the Department of Perinatology of the University Hospital Robert Debré in Paris.
Population:
Thirty pregnant women with a gastroschisis affected fetus diagnosed antenatally.
Methods:
The biological results were expressed as multiples of the median with respect to a control population.
Main Outcome Measure:
Gestational age at delivery and the outcome of the infants were recorded and correlated with amniotic fluid total proteins, ferritin and digestive compounds.
Results:
There was a positive correlation (P < 0.01) between digestive compounds (except amylase at the final amnioexchange) and ferritin on the one hand, and all digestive compounds and total proteins concentration at the final amnioexchange on the other. In addition, among total proteins amylase and lipase, lipase concentrations were related with parameters of short term outcome (P < 0.05).
Conclusion:
Amniotic total proteins and ferritin are elevated in fetuses presenting with gastroschisis as a consequence of an inflammatory process. Inflammation may be induced by the presence of digestive compounds in the amniotic fluid. The concentrations of which may constitute a marker of short term outcome of the newborn infant.
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