Gazzolo Diego, Pluchinotta Francesca, Bashir Moataza, Aboulgar Hanna, Said Hala Mufeed, Iman Iskander, Ivani Giorgio, Conio Alessandra, Tina Lucia Gabriella, Nigro Francesco, Li Volti Giovanni, Galvano Fabio, Michetti Fabrizio, Di Iorio Romolo, Marinoni Emanuela, Zimmermann Luc J, Gavilanes Antonio D W, Vles Hans J S, Kornacka Maria, Gruszfeld Darek, Frulio Rosanna, Sacchi Renata, Ciotti Sabina, Risso Francesco M, Sannia Andrea, Florio Pasquale
Department of Maternal, Fetal and Neonatal Medicine, "C. Arrigo" Children's Hospital Alessandria, Italy.
Department of Cardiology and Laboratory Reasearch S. Donato Milanese University Hospital, Milan, Italy.
PLoS One. 2015 Jan 8;10(1):e0115194. doi: 10.1371/journal.pone.0115194. eCollection 2015.
Perinatal asphyxia (PA) is a leading cause of mortality and morbidity in newborns: its prognosis depends both on the severity of the asphyxia and on the immediate resuscitation to restore oxygen supply and blood circulation. Therefore, we investigated whether measurement of S100B, a consolidated marker of brain injury, in salivary fluid of PA newborns may constitute a useful tool for the early detection of asphyxia-related brain injury.
We conducted a cross-sectional study in 292 full-term newborns admitted to our NICUs, of whom 48 suffered PA and 244 healthy controls admitted at our NICUs. Saliva S100B levels measurement longitudinally after birth; routine laboratory variables, neurological patterns, cerebral ultrasound and, magnetic resonance imaging were performed. The primary end-point was the presence of neurological abnormalities at 12-months after birth.
S100B salivary levels were significantly (P<0.001) higher in newborns with PA than in normal infants. When asphyxiated infants were subdivided according to a good (Group A; n = 15) or poor (Group B; n = 33) neurological outcome at 12-months, S100B was significantly higher at all monitoring time-points in Group B than in Group A or controls (P<0.001, for all). A cut-off >3.25 MoM S100B achieved a sensitivity of 100% (CI5-95%: 89.3%-100%) and a specificity of 100% (CI5-95%: 98.6%-100%) as a single marker for predicting the occurrence of abnormal neurological outcome (area under the ROC curve: 1.000; CI5-95%: 0.987-1.0).
S100B protein measurement in saliva, soon after birth, is a useful tool to identify which asphyxiated infants are at risk of neurological sequelae.
围产期窒息（PA）是新生儿死亡和发病的主要原因：其预后既取决于窒息的严重程度，也取决于恢复氧气供应和血液循环的即时复苏。因此，我们研究了在PA新生儿唾液中测量S100B（一种公认的脑损伤标志物）是否可能成为早期检测窒息相关脑损伤的有用工具。
我们对入住我院新生儿重症监护病房（NICU）的292名足月儿进行了一项横断面研究，其中48名患有PA，244名是入住我院NICU的健康对照。出生后纵向测量唾液S100B水平；进行常规实验室检查、神经学检查、脑部超声和磁共振成像。主要终点是出生后12个月时神经异常的存在情况。
PA新生儿的唾液S100B水平显著高于正常婴儿（P<0.001）。当根据出生后12个月时良好（A组；n = 15）或不良（B组；n = 33）的神经学结局对窒息婴儿进行细分时，B组在所有监测时间点的S100B均显著高于A组或对照组（所有P<0.001）。作为预测异常神经学结局的单一标志物，S100B>3.25倍中位数（MoM）的截断值实现了100%的敏感性（95%置信区间：89.3%-100%）和100%的特异性（95%置信区间：98.6%-100%）（ROC曲线下面积：1.000；95%置信区间：0.987-1.0）。
出生后不久测量唾液中的S100B蛋白是识别哪些窒息婴儿有神经后遗症风险的有用工具。
