Amniotic fluid beta-endorphin: a prognostic marker for gastroschisis?
OBJECTIVE
The aim of this work was to study amniotic fluid beta-endorphin as a potential predictor for postnatal morbidity in gastroschisis.


METHODS
Beta-endorphin was assayed in 43 amniotic fluid samples from 13 pregnant women with fetal gastroschisis undergoing diagnostic amniocentesis or therapeutic amnioinfusion and compared with 33 controls. Within the gastroschisis group, the authors investigated the relationship between postnatal morbidity and the peak value of amniotic fluid beta-endorphin (AFBE).


RESULTS
Ten AFBE values in 6 cases of gastroschisis were above the upper limit of the 95% confidence interval derived from controls. Postnatal morbidity was significantly higher when peak AFBE exceeded 10 microg/L (n = 4 pregnancies) compared with below 5 microg/L (n = 9 pregnancies), as shown by mean duration of mechanical ventilation (15.2 v 3 days; P =.01), of parenteral feeding (77 v. 18.7 days; P =.04), and of hospitalization (84 v 32.2 days; P =.04). There was no statistically significant association between postnatal morbidity markers and prenatal dilation of fetal bowel.


CONCLUSIONS
The most severe cases of gastroschisis are associated with high levels of AFBE. The authors speculate that this fetal hormonal response could result from stress or pain caused by prenatal bowel damage.
Mahieu-Caputo
Dominique
D
Biochemistry Department, Hôpital Ambroise Paré, Boulogne, France.
Muller
Françoise
F
Jouvet
Philippe
P
Thalabard
Jean-Christophe
JC
Jouannic
Jean-Marie
JM
Nihoul-Fekété
Claire
C
Dumez
Yves
Y
Dommergues
Marc
M
D000649:Amniocentesis; D000653:Amniotic Fluid / Q000737:chemistry*; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D020139:Gastroschisis / Q000175:diagnosis* / Q000196:embryology / Q000453:epidemiology; D006801:Humans; D007410:Intestinal Diseases / Q000196:embryology / Q000453:epidemiology; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D001615:beta-Endorphin / Q000032:analysis*
D015415:Biomarkers; D001615:beta-Endorphin