A. Elimian et al., AMNIOTIC-FLUID NEURON-SPECIFIC ENOLASE - A ROLE IN PREDICTING NEONATAL NEUROLOGIC INJURY, Obstetrics and gynecology, 92(4), 1998, pp. 546-550
Objective: To determine the relationship between amniotic fluid (AF) n
euron-specific enolase and the development of neonatal intraventricula
r hemorrhage and periventricular leucomalacia. Methods: Thirty-nine AF
samples, obtained from women in preterm labor between 24 and 32 weeks
' gestation, were analyzed for neuron-specific enolase. All women deli
vered preterm neonates who had neurosonograms on the 3rd and 7th days
of life. The results of the neurosonograms were used to divide the stu
dy population first into normal and abnormal groups, then into normal,
minor, and major brain lesion groups. The groups were compared for th
e median neuron-specific enolase, proportion with values of 6 mu g/L o
r more, and other demographic characteristics, Results: There were no
differences between the groups' maternal and neonatal characteristics.
However, the abnormal group had significantly higher median value of
neuron-specific enolase than the normal group (9.5 mu g/L, and 2.0 mu
g/L, respectively; P < .001). The median neuron-specific enolase level
s for the major, minor, and normal groups were 9.75 mu g/L, 6.5 mu g/L
and 2.0 mu g/L, respectively (P < .001). The optimum cutoff point, wi
th a sensitivity of 89% and specificity of 100%, was 6 mu g/L; 89% of
the abnormals had values of 6 mu g/L or more, compared with none of th
e normals (P < .001). The risk of developing intraventricular hemorrha
ge or periventricular leucomalacia was 11.5 times greater when AF neur
on-specific enolase levels were 6 mu g/L or more. Conclusion: Amniotic
fluid neuron-specific enolase is a useful marker of neonatal neurolog
ic injury. (Obstet Gynecol 1995;92:546-50. (C) 1998 by The American Co
llege of Obstetricians and Gynecologists.).