15thWorldCongressinFetalMedicine
Neuralinjurymarkersinintrauterinegrowthrestrictionanditsrelationtoperinataloutcomes
MazaricoE,CumplidoR,MartinAncelA,LlurbaE,Gomez-RoigL
HospitalSantJoandeDéu-BCNatal,Barcelona,Spain
Objective
IUGRhaslongtermmetabolic,neurologicandcardiovascularconsequences.Amongthese,neurodevelopmenthasreceivedconsiderableattentionbecauseofitsimpacton
thequalityoflifeandbecausethemorbidityofIUGRisreallydependenttofetalcentralsysteminjury.Therefore,havingantenatalorearlyneonatalmarkersforpredicting
these complications is an important step in the management of IUGR. Neural injury markers (S100B protein and NSE) are proteins associated with neural tissue. Their
releaseintheplasmaincreaseswhenneuralinjuryoccurs,ascerebralhypoxia.Thus,withmeasurementofbrain-relatedproducts,pathologiceffectstothenervoussystem
canbepredicted.Theaimofthisstudyiscomparetheconcentrationsoftwoneuralinjurymarkers’(s100BandNSE)levelsinmaternalandfetalumbilicalserumofIUGR
fetuseswithnormalgrowthfetuses.AndinvestigatetherelationshipofthemwithDopplerfindingsandadverseperinataloutcomes.
Methods
This is a case-control prospective study, cooperative, among Spanish Maternal and Child Health Network (Retic SAMID) hospitals. Consecutive cases of IUGR singleton
pregnancieswereprospectivelyrecruitedovera12-monthperiod.Atthetimeofdelivery,maternalvenousbloodandfetalumbilicalarterialbloodsampleswerecollected.
SerumS100BproteinwasmeasuredbyLIAISON®S100(DiasSorinS.p.A,Italy)whichisaquantitativeautomatedsandwichchemiluminescentimmunoassaysforthein
vitrodeterminationofproteinS100Binhumanserum.SerumNSEwasmeasuredbyLIAISON®NSE(DiasSorinS.p.A,Italy)whichisaninvitroassayforthequantitative
determinationofNSEinhumanserum.
Results
Atotalof147pregnancieswereidentifiedasIUGRand107asnon-IUGR.TherewerenodifferencesbetweenbothgroupsintheconcentrationsofS100B.However,levelsof
NSEinmaternalserumandumbilicalcordsignificantlydifferedbetweengroups,withhighervaluesinIUGRcases(2.31innon-IUGRvs2.51inIUGRinmaternalserum
(p<0.05)and2.89innon-IUGRvs3.25inIUGRinumbilicalcord(p<0.05)).Noneofthemarkershaddifferentconcentrationsinanyofthecompartmentswhenaperinatal
orneonatalcomplicationoccurred.
Conclusion
Our study shows that S100B protein and NSE are not good neural injury markers to predict neonatal complications in IUGR fetuses, mainly in those IUGR with a low
incidenceofperinatalcomplicationsorwithoutsevereperinatalcomplications.