The effect of intrauterine growth restriction on circulating surfactant protein D concentrations in the perinatal period

Area of Science:

• Neonatal immunology
• Pulmonary medicine
• Perinatal research

Background:

• Surfactant protein D (SP-D) is crucial for innate immunity and lung health.
• Intrauterine growth restriction (IUGR) is associated with lung structural immaturity and increased respiratory risks.
• Understanding SP-D in IUGR pregnancies can offer insights into neonatal respiratory outcomes.

Purpose of the Study:

• To investigate circulating surfactant protein D (SP-D) concentrations in appropriate for gestational age (AGA) and intrauterine growth-restricted (IUGR) pregnancies.
• To explore the relationship between SP-D levels and fetal development in IUGR.
• To examine postnatal changes in SP-D and delivery mode influences.

Main Methods:

• Serum SP-D levels were measured in 40 mothers and their neonates (20 IUGR, 20 AGA) at birth (N1) and postnatal day 4 (N4).
• Statistical analyses, including correlation and group comparisons, were performed to assess SP-D concentrations.
• Infant customized centiles and gestational age were correlated with fetal SP-D levels.

Main Results:

• Fetal SP-D concentrations were significantly higher in the IUGR group compared to AGA.
• Higher fetal SP-D levels in IUGR correlated negatively with infant customized centiles and gestational age.
• SP-D concentrations were lower in fetuses than in neonates at N1 and N4, with higher levels in vaginally delivered IUGR infants at N1.

Conclusions:

• Elevated fetal SP-D in IUGR may indicate lung immaturity or accelerated maturation due to intrauterine factors.
• Postnatal increases in SP-D are observed, potentially influenced by delivery mode and breathing initiation.
• Placental function decline might affect fetal SP-D production, explaining correlations with gestational age.