Diagnostic accuracy of S100B urinary testing at birth in full-term asphyxiated newborns to predict neonatal death.
BACKGROUND
Neonatal death in full-term infants who suffer from perinatal asphyxia (PA) is a major subject of investigation, since few tools exist to predict patients at risk of ominous outcome. We studied the possibility that urine S100B measurement may identify which PA-affected infants are at risk of early postnatal death.


RESULTS
In a cross-sectional study between January 1, 2001 and December 1, 2006 we measured S100B protein in urine collected from term infants (n = 132), 60 of whom suffered PA. According to their outcome at 7 days, infants with PA were subsequently classified either as asphyxiated infants complicated by hypoxic ischemic encephalopathy with no ominous outcome (HIE Group; n = 48), or as newborns who died within the first post-natal week (Ominous Outcome Group; n = 12). Routine laboratory variables, cerebral ultrasound, neurological patterns and urine concentrations of S100B protein were determined at first urination and after 24, 48 and 96 hours. The severity of illness in the first 24 hours after birth was measured using the Score for Neonatal Acute Physiology-Perinatal Extension (SNAP-PE). Urine S100B levels were higher from the first urination in the ominous outcome group than in healthy or HIE Groups (p<0.001 for all), and progressively increased. Multiple logistic regression analysis showed a significant correlation between S100B concentrations and the occurrence of neonatal death. At a cut-off >1.0 microg/L S100B had a sensitivity/specificity of 100% for predicting neonatal death.


CONCLUSIONS
Increased S100B protein urine levels in term newborns suffering PA seem to suggest a higher risk of neonatal death for these infants.
Gazzolo
Diego
D
Department of Obstetrics, G Gaslini Children's Hospital University of Genoa, Genoa, Italy. dgazzolo@hotmail.com
Frigiola
Alessandro
A
Bashir
Moataza
M
Iskander
Iman
I
Mufeed
Hala
H
Aboulgar
Hanna
H
Venturini
Pierluigi
P
Marras
Mauro
M
Serra
Giovanni
G
Frulio
Rosanna
R
Michetti
Fabrizio
F
Petraglia
Felice
F
Abella
Raul
R
Florio
Pasquale
P
D001238:Asphyxia Neonatorum / Q000175:diagnosis* / Q000401:mortality*; D003430:Cross-Sectional Studies; D006801:Humans; D007231:Infant, Newborn; D009414:Nerve Growth Factors / Q000652:urine*; D011379:Prognosis; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000652:urine*; D012680:Sensitivity and Specificity; D016482:Urinalysis
D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human