92 Increased S100B Urinary Measurements at Birth May Predict Neonatal Death in Preterm Newborns

Abstract

Background: To date no effective biochemical/biophysical tools exist to predict, among preterm infants, the cases at higher risk for perinatal death. The present study is aimed at investigating whether the measurement of S100B protein in urine may represent a useful tool to early identify patients at risk of postnatal death.

Methods: A retrospective case-control study was performed to measure S100B protein in urine fluid of preterm infants (n= 165) admitted to three tertiary NICUs (from January 1, 1999 to May 31, 2003), of whom a subgroup (n= 11) suffered spontaneous early neonatal death within the first week of age. Routine laboratory variables, neurological patterns and urine concentrations of S100B protein were determined at four time-points (at first urination, and after 24, 48, 96 hour). Ultrasound imaging were assessed within the first 72 hours from birth.

Results: S100B levels, in infants who died within the first week of age, were already higher at first urination and progressively increased from 24 to 96 hour time-points than controls (p< 0.001, for all). Multiple logistic regression analysis showed a significant correlation between S100B protein urine concentrations and the occurrence of neonatal death. An S100B concentration cut-off of 12.7 MoM at first urination had a sensitivity of 100 percent and a specificity of 98.3 percent for predicting an abnormal neonatal follow-up. The positive predictive value was of 78.57%, the negative predictive value was of 100%.

Conclusion: Measurement of S100B protein urine levels in newborns, could be aid to identify newborns at higher risk for developing neonatal death.

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