title: Erythropoietin in amniotic fluid as a potential marker in distinction between growth restricted and constitutionally small fetuses.
abstract: OBJECTIVE
  To determine if there is any difference in amniotic fluid erythropoietin (EPO) concentration between fetuses small for gestational age (SGA) and appropriate for gestational age (AGA), and between the constitutionally small (CSF) and growth-restricted (GRF) fetuses.
  
  
  METHODS
  EPO concentrations in the amniotic fluid samples were determined by EpoELISA test in 38 pregnancies with SGA and 15 pregnancies with AGA fetuses. In the SGA group we measured Ponderal index (PI) and skin-fold thickness (SFT). If PI and/or SFT were below 10th percentile the neonate was GRF. If both PI and SFT were above 10th percentile the neonate was CSF.
  
  
  RESULTS
  Higher levels of EPO were detected in the SGA in comparison to the AGA fetuses (p < 0.01). EPO concentration was higher in GRF compared to CSF (p < 0.05). The EPO cut-off level between SGA and AGA was 6.81 IU/L (sensitivity 92.3%; specificity 73.3%), and between GRF and CSF was 9.8 IU/L (sensitivity 81%; specificity 80%).
  
  
  CONCLUSIONS
  The preliminary results of this study suggest that amniotic fluid erythropoietin concentration is elevated in growth-restricted fetuses and could potentially be used for distinction between growth restricted and constitutionally small fetuses. Confirmation of these results on a larger group of pregnant women is needed.
authors.affiliation: Department of High-risk Pregnancies, University Clinic for Gynecology and Obstetrics "Narodni front", Medical School, University of Belgrade , Belgrade , Serbia .
authors.forename: Zeljko
authors.initials: Z
authors.lastname: Mikovic
authors.forename: Vesna
authors.initials: V
authors.lastname: Mandic
authors.forename: Vladimir
authors.initials: V
authors.lastname: Parovic
authors.forename: Mirjana
authors.initials: M
authors.lastname: Bogavac
authors.forename: Natasa
authors.initials: N
authors.lastname: Simin
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry* / Q000378:metabolism; D015415:Biomarkers / Q000032:analysis* / Q000378:metabolism; D001724:Birth Weight; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D004921:Erythropoietin / Q000032:analysis* / Q000378:metabolism; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D007236:Infant, Small for Gestational Age; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D013008:Somatotypes; D055815:Young Adult
chemical_list: D015415:Biomarkers; C554270:EPO protein, human; D004921:Erythropoietin
keywords: Amniotic fluid; erythropoietin; intrauterine growth restriction