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High Maternal Blood S100B Concentrations in Pregnancies Complicated by Intrauterine Growth Restriction and Intraventricular Hemorrhage

¹ Department of Pediatrics and Neuroscience, G. Gaslini Children’s University Hospital, Genoa, Italy.
² Department of Maternal, Fetal and Neonatal Health, G. Garibaldi Hospital, Catania, Italy.
³ Laboratory of Perinatal Medicine and Molecular Biology, University "La Sapienza", Rome, Italy.
⁴ Center of Fetal and Perinatal Medicine, Galliera Hospital, Genoa, Italy.
⁵ Institute of Anatomy and Cell Biology, Catholic University, Rome, Italy.
⁶ Department of Obstetrics and Gynecology, University of Siena, Siena, Italy.

^aAddress correspondence to this author at: Department of Maternal, Fetal and Neonatal Health, G. Garibaldi Hospital, Via Palermo 511, I-95100 Catania, Italy. Fax 39-095-759-5208; e-mail dgazzolo{at}hotmail.com.

Background: Intrauterine growth restriction (IUGR) is associated with perinatal mortality and with neurologic damage from intraventricular hemorrhage (IVH). We investigated whether S100B, a neural protein found in high concentrations after cell injury in the nervous system, is increased in serum of women whose pregnancies are complicated by IUGR and whose newborns develop IVH. We also explored the prognostic accuracy of maternal serum S100B for IVH in the newborn.

Methods: We conducted a case–control study of 106 pregnancies complicated by IUGR, including a subgroup (n = 26) who developed IVH after birth, and 212 unaffected pregnancies matched for gestational age. Ultrasound examination, Doppler velocimetry patterns (in the utero-placental vessels and middle cerebral artery), and maternal blood collection were performed before birth; cerebral ultrasound and neurologic examinations were performed after birth.

Results: S100B was higher (P <0.001) in IUGR pregnancies complicated by IVH than in those that were not and in controls. At a cutoff of 0.72 µg/L, sensitivity was 100% [95% confidence interval (95% CI), 87%–100%] and specificity was 99.3% (97.5%–99.9%) for prediction of IVH (area under the ROC curve, 0.999). The prevalence of IVH was 8.2% in the whole study population, 93% (95% CI, 83.6%–100%) in those with maternal S100B >0.72 µg/L, and 0% (0%–2.5%) in those with maternal S100B <0.72 µg/L.

Conclusion: For prediction of IVH, measurements of maternal S100B may be useful at times before clinical, laboratory, and ultrasound patterns can identify risk of IVH.

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