The Significance of Epidermal Growth Factor in Noninvasively Obtained Amniotic Fluid Predicting Respiratory Outcomes of Preterm Neonates

Abstract

Preterm premature rupture of membranes (PPROM) interrupts normal lung development, resulting in neonatal respiratory morbidity. Although post-PPROM risks have been researched, only a few studies have investigated noninvasively obtained amniotic fluid (AF) to predict neonatal outcomes. In this study, we aimed to determine whether epidermal growth factor (EGF) in vaginally-collected AF is a significant predictor of neonatal respiratory outcomes after PPROM. We analyzed EGF in vaginally-obtained AF from 145 women with PPROM at 22–34 weeks of gestation. The following neonatal outcomes were included: respiratory distress syndrome, surfactant need, duration and type of respiratory support, and bronchopulmonary dysplasia. We found that EGF concentration was associated with gestational age, and its medians were lower in neonates with respiratory morbidities than unaffected ones. EGF concentrations gradually declined, the lowest being in the most clinically ill patients. EGF < 35 pg/mL significantly predicted the odds of severe respiratory outcomes. EGF in noninvasively collected AF may be a reliable predictor for respiratory outcomes of preterm neonates with PPROM before 34 weeks of gestation. The results of our study may have implications for further research both in noninvasive amniotic fluid analysis and the management of patients after PPROM.

Causes of preterm birth: Genetic factors in preterm birth and preterm infant phenotypes

“…Nevertheless, the determination of this disorder, at least partially, derives before birth, reflects the special phenotype of the amniotic fluid proteome and correlates with the sPB phenotype. 52 The proteome unique to the PB phenotype due to the translation process may imply changes in the genome. Association studies on the role of genetic variants in BPD and sPB could elucidate the nature of their occurrence and connection.…”

“…PBD may evidently be a consequence of severe prematurity. Nevertheless, the determination of this disorder, at least partially, derives before birth, reflects the special phenotype of the amniotic fluid proteome and correlates with the sPB phenotype 52 . The proteome unique to the PB phenotype due to the translation process may imply changes in the genome.…”