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Published on: August 9, 2019
Calprotectin in human cord blood: relation to perinatal parameters and restricted fetal growth
Sofia Liosi1, Despina D Briana, Dimitrios Gourgiotis
1Division of Neonatal, 2nd Department of Obstetrics and Gynecology, Athens University Medical School, Athens, Greece.
Insights
Cord blood calprotectin levels do not reflect intrauterine growth restriction (IUGR) at birth. However, calprotectin concentrations increase with gestational age in IUGR and are lower in cesarean births, suggesting inflammation differences.
Area of Science:
- Perinatal medicine
- Immunology
- Biochemistry
Background:
- Calprotectin is a protein elevated in inflammatory conditions, released by activated neutrophils.
- Neutrophil activation and apoptosis are implicated in intrauterine growth restriction (IUGR).
Purpose of the Study:
- To determine cord blood calprotectin levels in intrauterine-growth-restricted (IUGR) and appropriate-for-gestational-age (AGA) neonates.
- To correlate cord blood calprotectin with perinatal demographic parameters.
Main Methods:
- Cord blood calprotectin concentrations were measured in term singleton pregnancies.
- Participants included IUGR (n=50) and AGA (n=110) neonates.
- Correlations with perinatal data were analyzed.
Main Results:
- No significant difference in cord blood calprotectin between IUGR and AGA groups at birth.
- In IUGR, calprotectin increased with gestational week (P=0.006).
- Cesarean sections showed lower calprotectin than vaginal deliveries (P<0.001), indicating differential inflammatory responses.
- Birth weight, customized centile, gender, maternal age, and parity did not affect cord blood calprotectin.
Conclusions:
- Cord blood calprotectin at term is independent of intrauterine growth, gender, parity, and maternal age.
- Calprotectin levels at birth may not accurately reflect the increased neutrophil activation and apoptosis expected in IUGR.
- Delivery mode influences cord blood calprotectin levels, suggesting inflammatory differences.
Objective:
To determine cord blood levels of calprotectin, a protein that is increased in inflammatory states and released by activated neutrophils has apoptosis-inducing activity.
Materials And Methods:
Cord-blood calprotectin concentrations were determined in intrauterine-growth-restricted (IUGR, usually associated with increased neutrophil activation and apoptosis, n=50) and appropriate-for-gestational-age (AGA, n=110) single full-term pregnancies, and were correlated with perinatal demographic parameters.
Results:
No significant differences exists between the IUGR and AGA groups, implying that calprotectin at birth does not reflect increased neutrophil activation and apoptosis expected in IUGR. However, in IUGRs, calprotectin concentrations increased with every gestational week [b=45.3, 95% confidence interval (CI): 13.5-77.1, P=0.006], suggesting concomitant up-regulation of neutrophil activation and apoptosis. A combined group showed significantly decreased calprotectin concentrations in cesarean sections [b=-74.5, 95% CI: -115.2-(-33.9), P<0.001], pointing to excessive inflammatory response in vaginal deliveries. Finally, birth weight, customized centile, gender, maternal age and parity do not impact on cord blood calprotectin concentrations.
Conclusions:
Cord blood calprotectin concentrations at term are independent of intrauterine growth, gender, parity and maternal age and probably do not reflect the increased neutrophil activation and excessive apoptosis expected in IUGR.
