Diagnostic Accuracy of S100B Urinary Testing at Birth in Full-Term Asphyxiated Newborns to Predict Neonatal Death

Abstract

BackgroundNeonatal death in full-term infants who suffer from perinatal asphyxia (PA) is a major subject of investigation, since few tools exist to predict patients at risk of ominous outcome. We studied the possibility that urine S100B measurement may identify which PA-affected infants are at risk of early postnatal death.Methodology/Principal FindingsIn a cross-sectional study between January 1, 2001 and December 1, 2006 we measured S100B protein in urine collected from term infants (n = 132), 60 of whom suffered PA. According to their outcome at 7 days, infants with PA were subsequently classified either as asphyxiated infants complicated by hypoxic ischemic encephalopathy with no ominous outcome (HIE Group; n = 48), or as newborns who died within the first post-natal week (Ominous Outcome Group; n = 12). Routine laboratory variables, cerebral ultrasound, neurological patterns and urine concentrations of S100B protein were determined at first urination and after 24, 48 and 96 hours. The severity of illness in the first 24 hours after birth was measured using the Score for Neonatal Acute Physiology-Perinatal Extension (SNAP-PE). Urine S100B levels were higher from the first urination in the ominous outcome group than in healthy or HIE Groups (p<0.001 for all), and progressively increased. Multiple logistic regression analysis showed a significant correlation between S100B concentrations and the occurrence of neonatal death. At a cut-off >1.0 µg/L S100B had a sensitivity/specificity of 100% for predicting neonatal death.Conclusions/SignificanceIncreased S100B protein urine levels in term newborns suffering PA seem to suggest a higher risk of neonatal death for these infants.

Postmortem stability of S100B in the aqueous humor of northern fur seals (Callorhinus ursinus)

“…While the magnitude and speed of increase in S100B levels are unknown for asphyxiated pinnipeds, a previous study 6 found that severely brain-damaged asphyxiated human neonates had urinary S100B concentrations 30-60 times higher than normal neonates, and a concentration of >1.0 μg/l was 100% specific and sensitive for a fatal outcome. Urine levels exceeded this cutoff at the first postnatal urination, implying a rapid shift of S100B from the serum into the urine.…”

Biomarker Discovery by Mass Spectrometry in Cerebrospinal Fluid and Plasma after Global Hypoxia-Ischemia in Newborn Piglets

“…Several candidates from adult traumatic brain injury studies have been investigated as potential NE biomarkers [2,3]. These include protein S100-B (S100B) [4] and neuron-specific enolase. Both appear to correlate with HI severity and neurodevelopmental outcome, but are also elevated in conditions other than HI [5].…”

Cerebral White Matter Injuries Following a Hypoxic/Ischemic Insult During the Perinatal Period: Pathophysiology, Prognostic Factors, and Future Strategy of Treatment Approach. A Minireview

“…Qian et al [89] reported elevated levels of this protein in neonates with hypoxic-ischemic encephalopathy. Gazzolo et al [90] demonstrated that a high concentration of S100 had a sensitivity of 91.3% and a specificity of 94.6% for predicting the development of hypoxicischemic encephalopathy.…”