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Neural injury markers in intrauterine growth restriction and their relation to perinatal outcomes
E Mazarico1, E Llurba2, R Cumplido3
1BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Sant Joan de Deu and Hospital Clínic); Maternal and Child Health and Development Network II (SAMID II) (ISCIII); Institut de Recerca Sant Joan de Déu, Spain.
Insights
Neuron-specific enolase (NSE) levels were higher in fetuses with intrauterine growth restriction (IUGR) compared to appropriate growth-for-gestational-age (AGA) fetuses. However, neither NSE nor S100B protein concentrations correlated with adverse perinatal outcomes in IUGR.
Area of Science:
- Perinatal Medicine
- Neuroscience
- Biochemistry
Background:
- Intrauterine growth restriction (IUGR) is associated with increased risk of adverse neonatal outcomes.
- Neural injury markers like S100B protein and neuron-specific enolase (NSE) may help assess fetal well-being.
- Understanding these markers in IUGR is crucial for improved clinical management.
Purpose of the Study:
- Compare S100B protein and NSE concentrations in fetuses with IUGR versus appropriate growth-for-gestational-age (AGA).
- Investigate associations between these markers, Doppler abnormalities, and perinatal/neonatal outcomes.
Main Methods:
- Prospective, case-controlled study in a Spanish Maternal and Child Health Network.
- Measured fetal biometry and feto-placental Doppler parameters.
- Collected maternal and umbilical cord blood samples for S100B and NSE analysis.
Main Results:
- No significant difference in S100B protein levels between IUGR and AGA groups.
- Significantly higher NSE levels in both maternal and umbilical cord serum of IUGR fetuses compared to AGA fetuses.
- No correlation found between S100B or NSE levels and perinatal/neonatal complications.
Conclusions:
- While NSE levels differ between IUGR and AGA fetuses, they do not appear to predict adverse outcomes.
- S100B protein is not a reliable marker for assessing neural injury in IUGR fetuses in this cohort.
- Further research is needed to identify reliable biomarkers for predicting complications in IUGR.
Abstract:
BACKGROUNDThe aims of this study were to (i) compare the concentrations of two neural injury markers, S100B protein and neuron-specific enolase (NSE), in intrauterine growth-restricted (IUGR) fetuses and in fetuses with appropriate growth-for-gestational-age (AGA), and (ii) investigate potential relationships between concentrations of these markers, Doppler abnormalities, and adverse perinatal or neonatal outcomes.METHODSThis was a case-controlled, cooperative, prospective study among Spanish Maternal and Child Health Network (Retic SAMID) hospitals. At inclusion, biometry for estimated fetal weight and feto-placental Doppler were measured. At the time of delivery, maternal venous blood and fetal umbilical arterial blood samples were collected. S100B and NSE concentrations were determined from these samples.RESULTSIn total, 254 pregnancies were included. Among these, 147 were classified as IUGR and 107 as AGA. There were no differences between the groups in S100B concentrations. However, levels of NSE in maternal and umbilical cord serum differed significantly between these groups (2.31 in AGA vs. 2.51 in IUGR in (P<0.05); and 2.89 in AGA vs. 3.25 in IUGR (P<0.05), respectively). No differences were observed in these neurological markers when stratified by perinatal or neonatal complications.CONCLUSIONAlthough some variations exist in these neurological markers, they did not correlate with perinatal or neonatal complications.
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