Midtrimester amniotic fluid tumor necrosis factor-alpha does not predict small-for-gestational-age infants.
OBJECTIVE
To evaluate the independent ability of midtrimester amniotic fluid tumor necrosis factor-alpha (TNF-alpha) in the prediction of small-for-gestational-age (SGA) infants.


METHODS
In this case-control study, patients delivering a SGA infant were matched with controls based on GA at delivery, maternal age, race, and parity. Patients with immune disease, chronic hypertension, diabetes, asthma, congenital hearts disease, multiple gestation, and fetal anomalies were excluded. Amniotic fluid samples were immunoassayed for TNF-alpha. Potential confounding variables evaluated were maternal serum alpha-fetoprotein level, smoking history, pregnancy induced hypertension, and neonatal gender. Statistical analysis included Fisher's exact test and ANOVA after log transformation with P < 0.05 considered significant.


RESULTS
Eighteen patients delivered SGA neonates and were matched with 41 controls. No significant differences were identified in the confounding variables between patients with SGA neonates and controls. Amniotic fluid TNF-alpha levels were not significantly different between patients subsequently delivering SGA neonates and controls [median 7.63 (range 0.25-16.1) pg/mL versus 9.39 (0.25-66.9) pg/mL, P = 0.8].


CONCLUSIONS
Midtrimester amniotic fluid TNF-alpha levels are not predictive of SGA neonates when compared with controls matched for gestational age at delivery.
Spong
C Y
CY
Perinatal Research Branch, NICHD, Washington DC, USA.
Scherer
D M
DM
Ghidini
A
A
Pezzullo
J C
JC
Salafia
C M
CM
Eglinton
G S
GS
D000653:Amniotic Fluid / Q000737:chemistry / Q000276:immunology*; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000276:immunology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
D015415:Biomarkers; D014409:Tumor Necrosis Factor-alpha