Department of Neonatology, Handan Maternal and Child Health Care Hospital, Handan, 056001, PR China.
Department of Neonatology and Neonatal Pathology, Handan Maternal and Child Health Care Hospital, No. 50, Li Ming Street, Hanshan District, Handan City, Hebei Province, 056001, China.
BMC Pediatr. 2024 Mar 13;24(1):178. doi: 10.1186/s12887-024-04663-9.
Amniotic fluid contamination (AFC) is a risk factor for neonatal hypoxic ischemic encephalopathy (HIE); however, the correlation between AFC level and the incidence and clinical grading of HIE, in addition to relevant biomarkers of brain damage, have not been assessed.
This single-center observational study included 75 neonates with moderate-to-severe HIE. The neonates with HIE were divided into four subgroups according to the AFC level: normal amniotic fluid with HIE group (NAF-HIE), I°AFC with HIE group (I°AFC-HIE), II°AFC with HIE group (II°AFC-HIE), and III°AFC with HIE group (III°AFC-HIE). The control groups consisted of 35 healthy neonates. The clinical grading of neonatal HIE was performed according to the criteria of Sarnat and Sarnat. Serum tau protein and S100B were detected by enzyme-linked immunosorbent assay kits. Correlations of serum tau protein and S100B were evaluated using the Pearson correlation analysis.
(1) The incidence of neonatal HIE in the NAF-HIE group was 20 cases (26. 7%), I°AFC-HIE was 13 cases (17.3%), II°AFC-HIE was 10 cases (13.3%), and III°AFC-HIE was 32 cases (42. 7%). The incidence of moderate-to-severe HIE in the I°-III°AFC-HIE groups was 73.3% (55/75). (2) In 44 cases with severe HIE, 26 cases (59.1%) occurred in the III°AFC-HIE group, which had a significantly higher incidence of severe HIE than moderate HIE (p < 0.05). In NAF-HIE and I°AFC-HIE groups, the incidence of moderate HIE was 45.2% and 29.0%, respectively, which was higher than that of severe HIE (X = 9.2425, p < 0.05; X = 5.0472, p < 0.05, respectively). (3) Serum tau protein and S100B levels in the HIE groups were significantly higher than in the control group (all p < 0.05), and were significantly higher in the III°AFC-HIE group than in the NAF-HIE and I°AFC-HIE groups (all p < 0.05). (4) Serum tau protein and S100B levels in the severe HIE group were significantly higher in the moderate HIE group (all p < 0.05). (5) Serum tau protein and S100B levels were significantly positively correlated (r = 0.7703, p < 0.0001).
Among children with severe HIE, the incidence of III°AFC was higher, and the levels of serum tau protein and S100B were increased. AFC level might be associated with HIE grading.
羊水污染（AFC）是新生儿缺氧缺血性脑病（HIE）的危险因素；然而，AFC 水平与 HIE 的发病率和临床分级以及相关的脑损伤生物标志物之间的相关性尚未得到评估。
本单中心观察性研究纳入了 75 例中重度 HIE 新生儿。根据 AFC 水平，将 HIE 新生儿分为四组：正常羊水合并 HIE 组（NAF-HIE）、I°AFC 合并 HIE 组（I°AFC-HIE）、II°AFC 合并 HIE 组（II°AFC-HIE）和 III°AFC 合并 HIE 组（III°AFC-HIE）。对照组由 35 例健康新生儿组成。新生儿 HIE 的临床分级根据 Sarnat 和 Sarnat 标准进行。采用酶联免疫吸附试验试剂盒检测血清 tau 蛋白和 S100B。采用 Pearson 相关分析评估血清 tau 蛋白和 S100B 的相关性。
（1）NAF-HIE 组新生儿 HIE 发生率为 20 例（26.7%），I°AFC-HIE 为 13 例（17.3%），II°AFC-HIE 为 10 例（13.3%），III°AFC-HIE 为 32 例（42.7%）。I°-III°AFC-HIE 组中中重度 HIE 的发生率为 73.3%（55/75）。（2）在 44 例重度 HIE 中，26 例（59.1%）发生在 III°AFC-HIE 组，其重度 HIE 的发生率明显高于中度 HIE（p<0.05）。在 NAF-HIE 和 I°AFC-HIE 组中，中度 HIE 的发生率分别为 45.2%和 29.0%，高于重度 HIE（X=9.2425，p<0.05；X=5.0472，p<0.05）。（3）HIE 组血清 tau 蛋白和 S100B 水平明显高于对照组（均 p<0.05），III°AFC-HIE 组明显高于 NAF-HIE 和 I°AFC-HIE 组（均 p<0.05）。（4）重度 HIE 组中，中度 HIE 组血清 tau 蛋白和 S100B 水平明显高于轻度 HIE 组（均 p<0.05）。（5）血清 tau 蛋白和 S100B 水平呈显著正相关（r=0.7703，p<0.0001）。
在重度 HIE 患儿中，III°AFC 发生率较高，血清 tau 蛋白和 S100B 水平升高。AFC 水平可能与 HIE 分级有关。
