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Neural injury markers to predict neonatal complications in intrauterine growth restriction

Abstract We assessed the neural injury markers (NIMs) in maternal and umbilical blood in preterm deliveries with and without intrauterine growth restriction (IUGR), and relationship between NIMs and neonatal complications. Deliveries between 24 and 34 weeks’ gestation with (study group) and without (control group) IUGR were included to the study. Three NIMs (s100B, neurone-specific enolase [NSE] and alpha-foetoprotein [AFP]) were investigated in umbilical arterial, umbilical venous and maternal venous serum. Thirty-two IUGR and twenty-nine non-IUGR pregnancies with preterm delivery were included. Maternal and umbilical arterial s100B levels were significantly higher in the study group, whereas there was no relationship among IUGR, AFP and NSE levels. In the study group, umbilical venous s100B and NSE levels were associated with perinatal mortality (p = 0.012, 0.005, respectively), necrotising enterocolitis (NEC) (p = 0.001, 0.04, respectively) and need for intubation (p = 0.001, 0.007, respectively). Negative predictive values for perinatal mortality and NEC were 100% and for need for intubation it was 92.8% when both s100B and NSE were below the cutoff line determined by the receiver-operating characteristic curves. Perinatal mortality, NEC and need for intubation can be predicted by assessment of umbilical venous s100B and NSE measurement during birth in IUGR newborns.