Abu Jawdeh Elie G, Van Eldik Linda J, Stevenson Jennifer, Patwardhan Abhijit, Westgate Philip M, Martin Richard, Bada Henrietta S
medRxiv. 2025 Sep 8:2025.09.05.25334486. doi: 10.1101/2025.09.05.25334486.
Intermittent hypoxemia (IH) is common in preterm infants and linked to brain injury. S100B is a glial-derived protein that rises early after neural injury and can be measured noninvasively in urine. We evaluated the relationship between IH burden and urinary S100B in preterm infants ≤32 weeks' gestation.
Preterm infants ≤32 weeks' gestation were prospectively enrolled. Oxygen saturation was continuously monitored, and IH profiles were quantified using validated algorithms. Urine S100B was measured by ultrasensitive immunoassay. Infants with severe intraventricular hemorrhage were excluded. Spearman correlations examined associations between IH metrics and urinary S100B, overall and by gestational age subgroups.
Twenty-one infants contributed 53 urine samples. Higher urinary S100B correlated with greater IH frequency, percent time in hypoxemia, longer event duration, and lower nadir saturations (all p <0.05). Short events showed the strongest correlations for frequency ( = 0.50) and percent time ( = 0.54), while longer events correlated most strongly with nadir ( = -0.66). Extremely preterm infants demonstrated stronger associations for nadir and duration; very preterm infants only for percent time. S100B increased stepwise across IH burden tertiles.
Urinary S100B increases with IH burden, with patterns varying by gestational age and event duration. Urinary S100B may provide an early, noninvasive biomarker of IH-related brain injury in preterm infants.
间歇性低氧血症（IH）在早产儿中很常见，并且与脑损伤有关。S100B是一种神经胶质衍生蛋白，在神经损伤后早期升高，并且可以通过尿液进行无创测量。我们评估了胎龄≤32周的早产儿中IH负担与尿S100B之间的关系。
前瞻性纳入胎龄≤32周的早产儿。持续监测氧饱和度，并使用经过验证的算法对IH情况进行量化。通过超敏免疫测定法测量尿S100B。排除患有严重脑室内出血的婴儿。采用Spearman相关性分析来研究IH指标与尿S100B之间的关联，包括总体情况以及按胎龄亚组分析。
21名婴儿提供了53份尿液样本。尿S100B水平越高，与更高的IH频率、低氧血症持续时间百分比、更长的事件持续时间以及更低的最低饱和度相关（所有p<0.05）。短时间事件在频率（r = 0.50）和持续时间百分比（r = 0.54）方面显示出最强的相关性，而长时间事件与最低饱和度相关性最强（r = -0.66）。极早产儿在最低饱和度和持续时间方面表现出更强的关联；晚期早产儿仅在持续时间百分比方面有较强关联。S100B在IH负担三分位数中呈逐步升高趋势。
尿S100B随IH负担增加而升高，其模式因胎龄和事件持续时间而异。尿S100B可能为早产儿IH相关脑损伤提供一种早期、无创的生物标志物。
