Biochemical measurement in cord blood as an indicator of neonatal maturity

Neonates were categorized by gestational scoring (G. Score) using physical and neurological signs, into two groups: TERM and preterm (PRE) using a score corresponding to approximately 38 weeks of gestation as the dividing point. Cord blood concentrations of alphafetoprotein (AFP), fetal hemoglobin (HGF), prealbumin (PALB), creatinine (CRE), and pseudocholinesterase (PC) were determined. The CRE, AFP, and HGF were divided by birthweight in grams (WT) to give three additional markers: CRE/WT, AFP/WT and HGF/WT. Strong Pearsonian correlations between CRE/WT, AFP/WT, and HGF/WT, and G. Scores in the PRE group were obtained. Histograms of AFP/WT and HGF/WT values gave non-Gaussian distributions and resulted in the clear separation of a group of extremely premature infants from the rest of the population. The plots also revealed substantial separation between the TERM and PRE groups. The CRE/WT was predominantly Gaussian, with separation of a group of neonates including the six very preterm infants. It is concluded that CRE/WT, AFP/WT, and HGF/WT have the greatest potential as maturity markers, while PC and PALB have little if any potential.