title: Comparison of Umbilical Serum Copeptin Relative to Erythropoietin and S100B as Asphyxia Biomarkers at Birth.
abstract: BACKGROUND
  Birth asphyxia, estimated to account for a million neonatal deaths annually, can cause a wide variety of neurodevelopmental impairments. There is a need to develop new, swift methods to identify those neonates who would benefit from neuroprotective treatments such as hypothermia.
  
  
  OBJECTIVE
  To examine the utility of cord serum copeptin, a stable byproduct of arginine vasopressin release, as a biomarker of birth asphyxia based on a comparison with 2 biomarkers of hypoxia and brain trauma: erythropoietin and S100B.
  
  
  METHODS
  The study population consisted of 140 singleton, term neonates: 113 controls and 27 with birth asphyxia (2/3 criteria met: umbilical artery pH <7.10, base excess ≤12 mmol/L, and 5-min Apgar score <7). All deliveries were planned vaginal, but 51 neonates were born by emergency cesarean section. Copeptin, S100B, and erythropoietin levels in umbilical artery samples were measured by immunoassays.
  
  
  RESULTS
  Copeptin correlated in the entire study population more strongly with umbilical artery base excess than S100B and erythropoietin, and only copeptin correlated with arterial pH. Furthermore, only copeptin levels were significantly higher in cases of birth asphyxia, and in vaginally born neonates they were found to increase as a function of labor duration. Copeptin was elevated in neonates born via vacuum extraction, whereas erythropoietin levels showed a slight increase after emergency cesarean section.
  
  
  CONCLUSIONS
  In this study population, S100B and erythropoietin were not valid biomarkers of birth asphyxia. In contrast, our work suggests that copeptin has high potential to become a routinely used biomarker for acute birth asphyxia and neonatal distress.
authors.affiliation: Department of Biosciences, University of Helsinki, Helsinki, Finland.
authors.forename: Milla
authors.initials: M
authors.lastname: Summanen
authors.forename: Laura
authors.initials: L
authors.lastname: Seikku
authors.forename: Petri
authors.initials: P
authors.lastname: Rahkonen
authors.forename: Vedran
authors.initials: V
authors.lastname: Stefanovic
authors.forename: Kari
authors.initials: K
authors.lastname: Teramo
authors.forename: Sture
authors.initials: S
authors.lastname: Andersson
authors.forename: Kai
authors.initials: K
authors.lastname: Kaila
authors.forename: Leena
authors.initials: L
authors.lastname: Rahkonen
mesh_terms: D001238:Asphyxia Neonatorum / Q000097:blood* / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D004921:Erythropoietin / Q000097:blood*; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D008297:Male; D036801:Parturition / Q000097:blood*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood*; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C554270:EPO protein, human; D006020:Glycopeptides; D064568:S100 Calcium Binding Protein beta Subunit; C579160:S100B protein, human; C048197:copeptins; D004921:Erythropoietin
keywords: Arginine vasopressin; Birth asphyxia; Copeptin; Erythropoietin; Neonate; S100B