title: Urinary S100B protein concentrations are increased in intrauterine growth-retarded newborns.
abstract: BACKGROUND
  Intrauterine growth retardation is one of the major causes of perinatal mortality and morbidity. To date, there are no reliable methods to detect brain damage in these patients.
  
  
  METHODS
  We conducted a case-control study in tertiary NICUs from December 2001 to December 2003 with 42 intrauterine growth retardation infants and 84 controls. Routine laboratory variables, neurologic outcome at 7-day follow-up, ultrasound imaging, and urine concentrations of S100B protein were determined at 5 time points. Urine S100B levels were measured by an immunoluminometric assay at first urination, 24, 48, and 72 hours, and 7 days after birth. Routine laboratory parameters and neurologic patterns were assessed at the same time as urine sampling.
  
  
  RESULTS
  S100B protein was significantly higher at all of the monitoring time points in urine taken from intrauterine growth retardation newborns than in control infants. When intrauterine growth retardation infants were corrected for the presence of abnormal (group A) or normal (group B) neurologic examination 7 days after birth, S100B was significantly higher at all of the predetermined monitoring time points in group A infants than in group B or controls. At a cutoff of 7.37 multiples of median at first urination, S100B achieved a sensitivity of 95% and a specificity of 99.1% as a single marker for predicting an adverse neurologic outcome. Twenty of 126 patients had neurologic abnormalities, making an overall prevalence of the disease in our population of 15.9% (pretest probability). With respect to the performance of S100B in predicting brain damage, its positive and negative predictive values were 91.0% and 99.0%, respectively.
  
  
  CONCLUSIONS
  Increased urine S100B protein levels in intrauterine growth retardation newborns in the first week after birth suggest the presence of brain damage reasonably because of intrauterine hypoxia. Longitudinal S100B protein measurements soon after birth are a useful tool to identify which intrauterine growth retardation infants are at risk of possible neurologic sequelae.
authors.affiliation: Department of Pediatrics, Obstetrics, and Reproductive Medicine, University of Siena, Siena, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Florio
authors.forename: Emanuela
authors.initials: E
authors.lastname: Marinoni
authors.forename: Romolo
authors.initials: R
authors.lastname: Di Iorio
authors.forename: Moataza
authors.initials: M
authors.lastname: Bashir
authors.forename: Sabina
authors.initials: S
authors.lastname: Ciotti
authors.forename: Renata
authors.initials: R
authors.lastname: Sacchi
authors.forename: Matteo
authors.initials: M
authors.lastname: Bruschettini
authors.forename: Mario
authors.initials: M
authors.lastname: Lituania
authors.forename: Giovanni
authors.initials: G
authors.lastname: Serra
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Michetti
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
authors.forename: Diego
authors.initials: D
authors.lastname: Gazzolo
mesh_terms: D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis*; D006801:Humans; D002534:Hypoxia, Brain / Q000503:physiopathology; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D009414:Nerve Growth Factors / Q000652:urine*; D012372:ROC Curve; D012307:Risk Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000652:urine*
chemical_list: D015415:Biomarkers; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human