Gazzolo D, Visser G H A, Lituania M, Sarli R, Bruschettini M, Michetti F, Bruschettini P L
Department of Pediatrics, Giannina Gaslini Children's University Hospital, Genoa, Italy.
J Matern Fetal Neonatal Med. 2002 Jun;11(6):378-84. doi: 10.1080/jmf.11.6.378.384.
We aimed to determine whether S100B protein levels in cord blood and the development of fetal behavioral states were altered and interrelated in small-for-dates (SFD) fetuses.
Umbilical cord blood samples were collected from 12 SFD fetuses with normal umbilical artery (UA) Doppler findings, from six SFD fetuses with abnormal Doppler waveform patterns and from 36 controls matched for gestational age. S100B protein levels were measured by means of a specific radioimmunoassay. Fetal behavioral state recordings were made before delivery by Cesarean section and data were expressed as percentage of quiet sleep coincidence (C1F), of activity state coincidence (C2-4F) and of no coincidence (NOC). Flow velocimetry waveforms were recorded from the uterine artery, UA and fetal middle cerebral artery (MCA).
Mean S100B protein levels in umbilical plasma were significantly higher in the six SFD infants with abnormal prenatal Doppler findings (3.31 +/- 0.65 microg/l) than in SFD infants with normal Doppler findings (1.56 +/- 0.35 microg/l) and in controls (1.23 +/- 0.43 microg/l). Similarly in these fetuses NOC was higher and C2F significantly lower (p < 0.05), but there was no significant difference in C1F. S100B concentrations were correlated with the UA pulsatility index (PI) (r = 0.78, p < 0.01), with the MCA PI (r = -0.78, p < 0.01) and with the UA PI/MCA PI ratio (r = 0.80, p < 0.01). Also, NOC and C2F percentages were correlated with the UA PI (r = 0.61, p < 0.01 and r = -0.61, p < 0.01, respectively), with the MCAPI (r = -0.72, p < 0.001 and r = 0.66, p < 0.01, respectively), and with the UA PI/MCA PI ratio (r = 0.60, p < 0.01 and r = -0.54, p < 0.05, respectively). NOC was also correlated with S100B protein (r = 0.48, p < 0.05); the correlation of S100B protein and C2F almost reached significance (r = -0.47, p < 0.05).
This study provides evidence of a relationship between a biochemical marker of brain development and/or integrity and the development of fetal behavioral states, offering additional information on brain maturation in normal and high-risk pregnancies.
我们旨在确定小于胎龄（SFD）胎儿脐带血中S100B蛋白水平以及胎儿行为状态的发育是否发生改变并相互关联。
从12例脐动脉（UA）多普勒检查结果正常的SFD胎儿、6例多普勒波形模式异常的SFD胎儿以及36例孕周匹配的对照组胎儿中采集脐带血样本。通过特定的放射免疫测定法测量S100B蛋白水平。在剖宫产分娩前进行胎儿行为状态记录，数据以安静睡眠符合率（C1F）、活动状态符合率（C2 - 4F）和不符合率（NOC）的百分比表示。记录子宫动脉、脐动脉和胎儿大脑中动脉（MCA）的血流速度波形。
产前多普勒检查结果异常的6例SFD婴儿脐血浆中S100B蛋白平均水平（3.31±0.65微克/升）显著高于多普勒检查结果正常的SFD婴儿（1.56±0.35微克/升）和对照组（1.23±0.43微克/升）。同样，在这些胎儿中，NOC较高，C2F显著较低（p<0.05），但C1F无显著差异。S100B浓度与脐动脉搏动指数（PI）相关（r = 0.78，p<0.01），与大脑中动脉PI相关（r = -0.78，p<0.01），与脐动脉PI/大脑中动脉PI比值相关（r = 0.80，p<0.01）。此外，NOC和C2F百分比分别与脐动脉PI相关（r = 0.61，p<0.01和r = -0.61，p<0.01），与大脑中动脉PI相关（r = -0.72，p<0.001和r = 0.66，p<0.01），与脐动脉PI/大脑中动脉PI比值相关（r = 0.60，p<0.01和r = -0.54，p<0.05）。NOC也与S100B蛋白相关（r = 0.48，p<0.05）；S100B蛋白与C2F的相关性几乎达到显著水平（r = -0.47，p<0.05）。
本研究提供了大脑发育和/或完整性的生化标志物与胎儿行为状态发育之间关系的证据，为正常和高危妊娠中的大脑成熟提供了额外信息。
