[The influence of delivery and perinatal risk factors on the concentration of cystatine C in umbilical cord blood].
Cystatin C--a low molecular protein, recognized as a sensitive marker of glomerular filtration rate and inhibitor of the lisosomal proteolitic enzymes in the organism. It is produced continuously and released to biological fluids. The concentration of cystatin C in the cord blood is higher and more diverse than in the peripheral blood with children and adults.


OBJECTIVE
To determinate the range of the concentrations cystatin C in the umbilical cord blood and to research the influence of delivery and perinatal risk factors on concentration of cystatin C in cord blood.


METHODS
The study included 444 newborns born by spontaneous deliveries and cesarean sections. In both subgroups, term neonates, preterm and some amount of newborns with additional perinatal risk factors (hipotrofia, infection, asphyxia) were found. Clinical evaluation, blood tests and USG examination were performed. Blood cord samples were analyzed entirely in the neonates with normal USG image of urinary tract was normal.


RESULTS
The mean cystatine C concentration in umbilical cord blood were 1.65 +/- 0.44 mg/l. There were not differences in the mean cystatin C concentration between term and preterm newborns without additional risk factors. The most important factor influencing cystatin C concentration appeared to be the kind of delivery In neonates born by spontaneous delivery mean cystatin C concentration was significantly higher (1.82 mg/l) than in neonates born by cesarean sections (1.48 mg/l). Mean cystatin C concentration was strongly correlated with a lactic acid concentration and a length of delivery.


CONCLUSIONS
Statistically higher concentrations of cystatine C were found in neonates born by spontaneous delivery. Laktacidemia is probably one of the factors responsible for elevation of cystatin C concentration in the cord blood. Higher cystatine C level can be recognized as a mechanism protecting the neonate from local or/and systemic proteolytic activity.
Centrum Medycznego Kształcenia Podyplomowego w Warszawie, Klinika Neonatologii. ula.jedrasiak@op.pl
Urszula
U
Jedrasiak
Jacek
J
Grygalewicz
D000328:Adult; D015415:Biomarkers / Q000097:blood; D002585:Cesarean Section / Q000009:adverse effects; D055316:Cystatin C; D015891:Cystatins / Q000097:blood*; D036861:Delivery, Obstetric / Q000009:adverse effects; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn / Q000097:blood* / Q000502:physiology; D019344:Lactic Acid / Q000097:blood; D008297:Male; D010500:Perinatology; D011247:Pregnancy; D012307:Risk Factors
D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D015891:Cystatins; D019344:Lactic Acid