High maternal blood S100B concentrations in pregnancies complicated by intrauterine growth restriction and intraventricular hemorrhage.
BACKGROUND
Intrauterine growth restriction (IUGR) is associated with perinatal mortality and with neurologic damage from intraventricular hemorrhage (IVH). We investigated whether S100B, a neural protein found in high concentrations after cell injury in the nervous system, is increased in serum of women whose pregnancies are complicated by IUGR and whose newborns develop IVH. We also explored the prognostic accuracy of maternal serum S100B for IVH in the newborn.


METHODS
We conducted a case-control study of 106 pregnancies complicated by IUGR, including a subgroup (n = 26) who developed IVH after birth, and 212 unaffected pregnancies matched for gestational age. Ultrasound examination, Doppler velocimetry patterns (in the utero-placental vessels and middle cerebral artery), and maternal blood collection were performed before birth; cerebral ultrasound and neurologic examinations were performed after birth.


RESULTS
S100B was higher (P <0.001) in IUGR pregnancies complicated by IVH than in those that were not and in controls. At a cutoff of 0.72 microg/L, sensitivity was 100% [95% confidence interval (95% CI), 87%-100%] and specificity was 99.3% (97.5%-99.9%) for prediction of IVH (area under the ROC curve, 0.999). The prevalence of IVH was 8.2% in the whole study population, 93% (95% CI, 83.6%-100%) in those with maternal S100B >0.72 microg/L, and 0% (0%-2.5%) in those with maternal S100B <0.72 microg/L.


CONCLUSIONS
For prediction of IVH, measurements of maternal S100B may be useful at times before clinical, laboratory, and ultrasound patterns can identify risk of IVH.
Department of Pediatrics and Neuroscience, G. Gaslini Children's University Hospital, Genoa, Italy. dgazzolo@hotmail.com
Diego
D
Gazzolo
Emanuela
E
Marinoni
Romolo
R
Di Iorio
Mario
M
Lituania
Mauro
M
Marras
Matteo
M
Bruschettini
Pierluigi
P
Bruschettini
Rosanna
R
Frulio
Fabrizio
F
Michetti
Felice
F
Petraglia
Pasquale
P
Florio
D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000151:congenital / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D009414:Nerve Growth Factors / Q000097:blood*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood*; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging
D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human