Abstract
Background: Isoprostanes (IP) are a novel marker of free radical-catalyzed lipid peroxidation. Recent evidence suggests that oxidative DNA damage occurs in pregnancies with fetal growth retardation (FGR). The aim of the present study was to analyse oxidative stress (OS) in amniotic fluid of pregnancies with FGR between weeks 15 and 18 week by evaluating IP concentrations.
Methods: We studied 236 women who underwent amniocentesis motivated by advanced maternal age. After exclusion criteria were considered, 78 women were enrolled: 54 had normal pregnancy with normal fetal growth (group I); 24 had IUGR (group II); 15 out of 24 IUGR fetuses were born AGA (subgroup IIa) and 9 were born SGA (subgroup IIb). Ultrasound criteria were applied to assess fetal growth on admission, two weeks later and at weeks 32–34. IP were determined in 2.0 ml of amniotic fluid. Data, expressed as mean ± SD, median and confidence interval were analysed using the STATA 6 statistical package.
Results: IP were higher in group II (154.05±43.32 pg/ml), subgroup IIa (158.27±58.17 pg/ml) and subgroup IIb (150.49±27.33 pg/ml) than group I (68.18±23.68 pg/ml; p<0.0001). The area under the ROC was 0.976 (95% CI: 0.913 – 0.997), showing 100% sensitivity (95% CI: 85.6 – 100) and 90.7% specificity (95% CI: 79.7 – 96.9) at a cutoff of 94 pg/ml. ROCs also enabled subgroup IIa and subgroup IIb to be distinguished. The area was 0.901 (95% CI: 0.812 – 0.957), showing a sensitivity of 100% (95%CI: 75.1 – 100) and a specificity of 75.5% (95%CI: 63.1 – 85.2) at a cutoff value of 94 pg/ml. Comparison of AGA percentiles between group I (F2-IP: 68.18±23.68 pg/ml) and subgroup IIa (F2-IP: 158.27±58.17 pg/ml) showed that 14 out of 15 babies in subgroup IIa and 7 out of 54 babies in group I were born AGA in the 10–25 centile range. The relative risk index between these two groups was 7.2 (CI: 3.42 – 14.34) indicating a risk of AGA (10–25°) 7.2 times higher in subgroup IIa.
Conclusion: This is the first report of elevated IP concentrations in amniotic fluid of pregnancies with IUGR. These results indicate that OS occurs early in fetal life in pregnancies with IUGR fetus.
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Longini, M., Perrone, S., Kenanidis, A. et al. 44 Oxidative Stress in Amniotic Fluid of Pregnancies with Fetal Growth Retardation. Pediatr Res 56, 471 (2004). https://doi.org/10.1203/00006450-200409000-00067
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DOI: https://doi.org/10.1203/00006450-200409000-00067