Amniotic fluid and umbilical cord serum erythropoietin in term and prolonged pregnancies

Abstract

Objective. Erythropoietin-a hormone regulating erythropoiesis-is a biomarker of chronic fetal hypoxia. High erythropoietin levels in fetal plasma and amniotic fluid are associated with increased risk of adverse neonatal outcome. Since the risk of perinatal morbidity and mortality is increased in pregnancies beyond 41 gestational weeks, we evaluated erythropoietin levels in amniotic fluid and umbilical cord serum in apparently low-risk term (≥37 gestational weeks) and prolonged pregnancies (≥41 gestational weeks) with labor induction. Study Design. This prospective cohort study comprised 93 singleton pregnancies at 37 +0-42 +1 gestational weeks, of which prolonged pregnancies numbered 63 (67.7%). Amniotic fluid samples were collected at time of labor induction by amniotomy. Umbilical cord blood samples for evaluation of pH, base excess, and umbilical cord serum erythropoietin were collected at birth. Erythropoietin levels were measured by immunochemiluminometric assay. Normal value of amniotic fluid erythropoietin level was defined as ≤3 IU/L, and abnormal value as ≥27 IU/L. Normal umbilical cord serum erythropoietin was defined as <40 IU/L. Data on maternal pregnancy and delivery characteristics and short-term neonatal outcomes such as Apgar score were obtained from the hospital charts. Associations were calculated using Spearman's rank correlation coefficient. The Chi-square test, Fisher's exact test and the Mann-Whitney U test were utilized to determine differences in the study groups. Results. Amniotic fluid erythropoietin levels correlated with gestational age (r=0.261, p=0.012) and were higher among prolonged pregnancies as compared to term pregnancies (p=0.005). There were 78 (83.9%) vaginal deliveries, and among these erythropoietin levels in amniotic fluid correlated with the levels in umbilical cord serum (r=0.513, p<0.000). Umbilical cord serum erythropoietin levels correlated with gestational age among vaginal deliveries (r=0.250, p=0.027). Erythropoietin levels in amniotic fluid and umbilical cord serum did not correlate with umbilical artery pH or base excess, or other adverse pregnancy outcome. Conclusions. In vaginal deliveries erythropoietin levels in amniotic fluid correlated with the levels in umbilical cord serum. Erythropoietin levels correlated with gestational age, probably due to weakening placental function and relative hypoxemia occurring in advanced gestation. However, in this relatively low-risk study population erythropoietin was not related to adverse delivery outcome.

Late-Pregnancy Fetal Hypoxia Is Associated With Altered Glucose Metabolism and Adiposity in Young Adult Offspring of Women With Type 1 Diabetes

“…Maternal gestational weight gain or breastfeeding could also have impacts on offspring metabolic health in adulthood, but we did not have access to this data. Further, due to the study design, prenatal AF EPO values were not available on the control participants; however, the likelihood of abnormal values in uncomplicated pregnancies of healthy women is very low ( 30 , 31 ). Finally, many of the invited offspring did not agree to participate in the study at young adult age, which reduced the available sample size, and may have introduced some selection bias.…”

Is obesity in pregnancy associated with signs of chronic fetal hypoxia?

“…The multivariable linear regression model included the potential confounders maternal age and parity 19 . In addition, estimates were adjusted for the mediators gestational age and mode of delivery 20‐22 . An erythropoietin concentration ≥60 U/L was considered as high.…”

Diagnostic significance of serum erythropoietin as a marker of perinatal brain damage in premature newborns with very low birth weight

“…Напротив, Seikku и соавт. [21] обнаружили, что концентрация сЭПО отличалась у доношенных и недоношенных новорожденных и коррелировала с ГВ. Следует отметить, что полученная исследователями корреляционная связь являлась слабой (r = 0,250).…”