Plasma Copeptin in Preterm Infants: A Highly Sensitive Marker of Fetal and Neonatal Stress

Benzing, Jörg; Wellmann, Sven; Achini, Federica; Letzner, Julia; Burkhardt, Tilo; Beinder, Ernst; Morgenthaler, Nils G.; Haagen, U; Bucher, Hans Ulrich; Bührer, Christoph; Lapaire, Olav; Szinnai, Gabor

doi:10.1210/jc.2010-2858

Cited by 39 publications

(29 citation statements)

References 12 publications

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“…There are many a priori reasons why copeptin might turn out to be a highly useful biomarker of birth asphyxia, and a number of previous observations point in this direction [4,5,21]. During birth, the HPA axis shows massive activation, which results in the release of AVP, and this response is further enhanced by various types of stressors.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Umbilical Serum Copeptin Relative to Erythropoietin and S100B as Asphyxia Biomarkers at Birth

Summanen¹,

Seikku²,

Rahkonen³

et al. 2017

Neonatology

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Background: Birth asphyxia, estimated to account for a million neonatal deaths annually, can cause a wide variety of neurodevelopmental impairments. There is a need to develop new, swift methods to identify those neonates who would benefit from neuroprotective treatments such as hypothermia. Objectives: To examine the utility of cord serum copeptin, a stable byproduct of arginine vasopressin release, as a biomarker of birth asphyxia based on a comparison with 2 biomarkers of hypoxia and brain trauma: erythropoietin and S100B. Methods: The study population consisted of 140 singleton, term neonates: 113 controls and 27 with birth asphyxia (2/3 criteria met: umbilical artery pH <7.10, base excess ≤12 mmol/L, and 5-min Apgar score <7). All deliveries were planned vaginal, but 51 neonates were born by emergency cesarean section. Copeptin, S100B, and erythropoietin levels in umbilical artery samples were measured by immunoassays. Results: Copeptin correlated in the entire study population more strongly with umbilical artery base excess than S100B and erythropoietin, and only copeptin correlated with arterial pH. Furthermore, only copeptin levels were significantly higher in cases of birth asphyxia, and in vaginally born neonates they were found to increase as a function of labor duration. Copeptin was elevated in neonates born via vacuum extraction, whereas erythropoietin levels showed a slight increase after emergency cesarean section. Conclusions: In this study population, S100B and erythropoietin were not valid biomarkers of birth asphyxia. In contrast, our work suggests that copeptin has high potential to become a routinely used biomarker for acute birth asphyxia and neonatal distress.

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Section: Discussionmentioning

confidence: 99%

“…In line with the underlying HPA-based mechanisms, copeptin levels in cord blood increase in different stress situations, such as infections and hypoxia, both in term and preterm pregnancies [4,5,21]. High copeptin levels at birth are related to acute adverse neonatal outcomes such as IVH [21]. …”

Section: Discussionmentioning

confidence: 99%

Comparison of Umbilical Serum Copeptin Relative to Erythropoietin and S100B as Asphyxia Biomarkers at Birth

Summanen¹,

Seikku²,

Rahkonen³

et al. 2017

Neonatology

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“…and Benzing et al found that compromised placental perfusion and chorioamnionitis were associated with significantly elevated cord copeptin levels in preterm infants born vaginally. (35) Copeptin is a biomarker of arginine vasopressin, which acts on multiple systems to increase blood pressure and water retention. Many studies suggest that copeptin levels might be useful in the early prediction of PE, as well as in the evaluation of the severity of the disease.…”

Section: Discussionmentioning

confidence: 99%

Can first trimester placental biomarkers copeptin and PP13 predict preeclampsia in advanced age nulliparous women?

Beljan¹,

Elveđi-Gašparović²,

Kalik-Oguić³

et al. 2017

Signa Vitae

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Preeclampsia (PE) affects approximately 3% of all pregnancies and it is still a major cause of adverse perinatal outcome. PE is a multisystem pregnancy related disorder of unknown aetiology with a progressive course and with no established therapy. In recent times excessive research was conducted on early screening for PE with an aim to reduce the prevalence of the disease with early medical treatment starting from the first trimester of pregnancy in the high-risk group. The aim of this study is to detect if the first trimester serum copeptin and PP13 can predict preeclampsia in advanced age nulliparous women. These are the preliminary results of an ongoing prospective study that will include 400 pregnant women undergoing first trimester aneuploidy screening at the Department for Obstetrics and Gynaecology, University Hospital Centre Zagreb. Maternal risk factors used as inclusion criteria in this study were: nulliparity and age >35. Participants were asked to complete a short questionnaire regarding personal and medical information. Blood samples were collected and maternal serum PP13 and copeptin levels were measured. Following the inclusion criteria, we analysed the records of 40 women who gave birth to this date. Three patients (7.5%) developed preeclampsia and eight (20%) had gestational hypertension (GH). All PE patients had elevated plasma copeptin. Our preliminary data suggests that early screening for PE at 11-13 weeks of gestation using biomarkers copeptin and PP-13, in combination with maternal risk factors, is by far the most promising method for early detection of PE in advanced age nulliparous women.

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“…Physiologically, when plasma osmolality is higher, copeptin levels are also increased [25]. Some authors demonstrated that in adults, during a hypertonic saline infusion and thirsting, there is a rise of serum osmolality which results in the increase in serum copeptin concentration [26]. …”

Section: Discussionmentioning

confidence: 99%

Serum NGAL and copeptin levels as predictors of acute kidney injury in asphyxiated neonates

et al. 2016

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BackgroundAcute kidney injury (AKI) is the most common complication of perinatal asphyxia. Recent research indicates that serum neutrophil gelatinase-associated lipocalin (NGAL) is an early marker for AKI, but there are the lacks of data about its use in term neonates with perinatal asphyxia.MethodsA prospective cohort study was conducted on 43 term neonates. Umbilical cord blood and 24 h after birth serum NGAL, copeptin, creatinine, and molality were measured in all asphyxiated and controls neonates.ResultsDuring the study period, 8 of asphyxiated nenates (18.6 %) suffered from AKI, while 35 newborns have no signs of AKI and 30 healthy infants. We did not observe any differences in creatinine and copeptin levels, as well as serum osmolality in all three investigated groups (AKI, no-AKI, and controls) in cord blood, and 24 h after birth. Serum NGAL levels in umbilical cord blood were significantly higher in the AKI group (174.3 ng/mL) compared with no-AKI (88.5 ng/mL, p = 0.01) and control groups (28.5 ng/mL, p < 0.001), and 24 h after birth (respectively, AKI 152.5 ng/mL vs no-AKI 74.9 ng/mL, p = 0.02 vs controls 39.1 ng/mL, p < 0.001). NGAL concentration showed a strong negative correlation to umbilical artery pH (Rho = −0.42, p = 0.04), base excess (Rho = −0.31, p = 0.03), and Apgar score in 1st min (Rho = −0.41, p = 0.02) and 5th min of life (Rho = −0.20, p = 0.001). ROC curve analysis demonstrated a good predictive value for NGAL levels (>140.7 ng/mL) which allows to diagnose AKI in asphyxiated patients with 88.9 % sensitivity (95 % CI 75–95 %) and 95.0 % specificity (95 % CI 76–99 %).ConclusionNGAL seems to be a promising marker, even in subclinical AKI in neonates, due to its high specificity, but copeptin did not meet expectations.

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Plasma Copeptin in Preterm Infants: A Highly Sensitive Marker of Fetal and Neonatal Stress

Abstract: Copeptin is a highly sensitive marker of perinatal stress.

Cited by 39 publications

References 12 publications

Comparison of Umbilical Serum Copeptin Relative to Erythropoietin and S100B as Asphyxia Biomarkers at Birth

Comparison of Umbilical Serum Copeptin Relative to Erythropoietin and S100B as Asphyxia Biomarkers at Birth

Can first trimester placental biomarkers copeptin and PP13 predict preeclampsia in advanced age nulliparous women?

Serum NGAL and copeptin levels as predictors of acute kidney injury in asphyxiated neonates

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