BIOCHEMICAL MONITORING OF FETAL DISTRESS WITH SERUM-IMMUNOREACTIVE ERYTHROPOIETIN

The ability of parameters like umbilical arterial pH and Apgar score t o predict and/or to reflect fetal distress are limited. It is known th at erythropoietin (EPO) increases when partial pressure of oxygen is i nsufficient for metabolic demand. Therefore we studied the levels of E PO in the cord blood of stressed neonates (n = 75). In addition, refer ence values for EPO were established in a group of healthy term infant s (n = 54) (mean +/- SD: 20.02 +/- 6.4[mU/ml]) and in premature infant s (n = 77) according to gestational age. A significant increase in EPO concentrations was found in the stressed group: 153.4 +/- 418.8 [mU/m l], p < 0.003 (n = 27) in acute stress; and 102.6 +/- 127.1 [mU/ml], p < 0.002 (n = 48) in chronic stress. However parameters like hemoglobi n, hematocrit, umbilical arterial pH and Apgar-score did not correlate with EPO values. A sensitivity of 59% and a specifity of 92% was calc ulated. We conclude that serum EPO concentrations are capable of detec ting acute and chronic stress and could be useful as a screening metho d. In part EPO concentrations also allow us to grade stress in pregnan cies that are complicated by diseases like preeclampsia.