Amniotic fluid neuron-specific enolase: a role in predicting neonatal neurologic injury?
OBJECTIVE
To determine the relationship between amniotic fluid (AF) neuron-specific enolase and the development of neonatal intraventricular hemorrhage and periventricular leucomalacia.


METHODS
Thirty-nine AF samples, obtained from women in preterm labor between 24 and 32 weeks' gestation, were analyzed for neuron-specific enolase. All women delivered preterm neonates who had neurosonograms on the 3rd and 7th days of life. The results of the neurosonograms were used to divide the study population first into normal and abnormal groups, then into normal, minor, and major brain lesion groups. The groups were compared for the median neuron-specific enolase, proportion with values of 6 microg/L or more, and other demographic characteristics.


RESULTS
There were no differences between the groups' maternal and neonatal characteristics. However, the abnormal group had significantly higher median value of neuron-specific enolase than the normal group (9.5 microg/L and 2.0 microg/L, respectively; P < .001). The median neuron-specific enolase levels for the major, minor, and normal groups were 9.75 microg/L, 6.5 microg/L and 2.0 microg/L, respectively (P < .001). The optimum cutoff point, with a sensitivity of 89% and specificity of 100%, was 6 microg/L; 89% of the abnormals had values of 6 microg/L or more, compared with none of the normals (P < .001). The risk of developing intraventricular hemorrhage or periventricular leucomalacia was 11.5 times greater when AF neuron-specific enolase levels were 6 microg/L or more.


CONCLUSIONS
Amniotic fluid neuron-specific enolase is a useful marker of neonatal neurologic injury.
Elimian
A
A
Department of Obstetrics and Gynecology, Westchester Medical Center, Valhalla, New York, USA.
Figueroa
R
R
Verma
U
U
Visintainer
P
P
Sehgal
P B
PB
Tejani
N
N
D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry*; D002543:Cerebral Hemorrhage / Q000175:diagnosis*; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D007969:Leukomalacia, Periventricular / Q000175:diagnosis*; D010751:Phosphopyruvate Hydratase / Q000032:analysis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012680:Sensitivity and Specificity
D010751:Phosphopyruvate Hydratase