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Biochemical Measurement of Neonatal Hypoxia
Published on: August 24, 2011
Diagnostic markers in combination improve the identification of growth-restricted neonates
Popi Sifianou1, Vasso Ktena, Helen Karga
1Dept. of Neonatology, General and Maternity Hospital, Elena Venizelou, Athens, Greece. posifi@otenet.gr
Insights
Diagnosing neonates with restricted growth is challenging. Combining simple diagnostic markers like anthropometrics and nutritional status improves detection accuracy for better infant health outcomes.
Area of Science:
- Neonatal Medicine
- Pediatric Endocrinology
- Biomarkers in Perinatal Health
Background:
- Accurate identification of growth-restricted neonates is limited by the absence of effective diagnostic tools.
- Fetal growth restriction (FGR) poses significant risks to infant health and long-term development.
Purpose of the Study:
- To evaluate the diagnostic value of combining multiple markers for detecting growth-restricted neonates.
- To assess the predictive power of anthropometric indices, nutritional status, and placental weight in identifying FGR.
Main Methods:
- Assessed anthropometric indices, nutritional status, and placental weight in 180 neonates (>36 weeks gestational age).
- Measured cord blood levels of Insulin-like Growth Factor I (IGF-I) and IGF Binding Protein 3 (IGFBP-3).
- Classified neonates into groups based on low anthropometric values (≤25th centile for gestational age) and performed statistical analyses.
Main Results:
- Neonates with multiple low anthropometric indices (Group(25)2) showed significantly lower IGF-I, IGFBP-3 levels, and placental weight compared to those with fewer low indices (P<0.0001).
- Combining anthropometric indices improved prediction of IGF-I, IGFBP-3 levels, and placental weight.
- Nutritional status significantly enhanced predictive models for all outcome variables.
Conclusions:
- A combined approach using simple diagnostic markers offers enhanced diagnostic potential for identifying growth-restricted neonates.
- This multi-marker strategy provides a more robust reference test than individual markers alone.
Background:
The identification of growth-restricted neonates is hampered by the lack of an appropriate diagnostic tool.
Aim:
To determine the value of combining diagnostic markers in detecting growth-restricted neonates.
Methods:
A set of anthropometric indices, nutritional status and placental weight were assessed in the study population soon after birth. Insulin-like growth factor I (IGF-I) and its binding protein 3 (IGFBP-3) were assayed in cord blood. Babies having low values (≤25th centile for gestational age) in 0, 1 or more of four anthropometric indices were classified as Group(25)0, Group(25)1 and Group(25)2, respectively. For statistical evaluation the Mann-Whitney test and a multiple regression analysis were performed.
Results:
One hundred-eighty (180) singleton babies of over 36 weeks of gestational age (GA) were studied. IGF-I, IGFBP-3 levels and placental weight were significantly lower in Group(25)2 than both Group(25)0 (P<0.0001) and Group(25)1 (p<0.0001 to p = 0.03). Group(25)1 and Group(25)0 did not differ significantly regarding IGF-I and IGFBP-3 levels (p values 0.09 and 0.13, respectively). The combination of anthropometric indices enhanced their ability to predict IGF-I, IGFBP-3 levels and placental weight; the nutritional status of the babies added power to all individual models in predicting the three outcome variables. Analogous results were obtained when the 10th (instead of the 25th) centile for GA was used for the anthropometric indices.
Conclusion:
The combination of simple diagnostic markers of growth restriction can define a reference test with enhanced diagnostic potential compared to the potential of the same markers in isolated use.
