Fetal electrocardiographic monitoring during labor in relation to cord blood levels of the brain-injury marker protein S-100.
BACKGROUND
Cord artery protein S-100 levels at birth are potential markers of brain damage after asphyxia. Our aim was to investigate if S-100 levels were elevated in neonates with indirect signs of asphyxia during birth. S-100 levels in cord blood were studied in relation to cardiotocography (CTG) and fetal electrocardiography (FECG) changes during birth and to acidemia in umbilical blood.


METHODS
This case-control study was performed in parallel to a large randomized controlled trial (RCT) studying FECG at birth. Protein S-100 samples were collected from 103 neonates at birth and related to the CTG and ECG changes during labor and to pH in umbilical blood.


RESULTS
Protein S-100 was significantly higher in neonates with umbilical artery blood pH<or=7.05, compared to neonates with pH>7.05. Furthermore, neonates with preterminal CTG patterns showed increased S-100 levels compared to neonates with normal CTG. Neonates having significant CTG and ECG changes, leading to intervention according to clinical guidelines, showed significantly higher S-100 levels compared to neonates without such indication of intervention.


CONCLUSIONS
A relation exists between S-100 in umbilical blood at birth, acidosis and pathological patterns in CTG and FECG during labor.
Stuart
Andrea
A
Department of Obstetrics and Gynecology, Lund University Hospital, Lund, Sweden.
Edvinsson
Linda
L
Källen
Karin
K
Olofsson
Per
P
Hellsten
Charlotte
C
Amer-Wåhlin
Isis
I
D000138:Acidosis / Q000097:blood* / Q000209:etiology; D000328:Adult; D001238:Asphyxia Neonatorum / Q000097:blood* / Q000150:complications; D015415:Biomarkers / Q000097:blood; D001930:Brain Injuries / Q000097:blood* / Q000209:etiology; D015148:Cardiotocography; D016022:Case-Control Studies; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007743:Labor, Obstetric / Q000097:blood*; D011247:Pregnancy; D009418:S100 Proteins / Q000097:blood*
D015415:Biomarkers; D009418:S100 Proteins