Elevated amniotic fluid stromal cell-derived factor-1alpha (SDF-1alpha) concentration in mid-gestation as a predictor of adverse birth outcomes.

BACKGROUND This study aimed to predict maternal and neonatal outcomes by measuring mid-trimester amniotic fluid stromal cell-derived factor-1alpha (SDF-1alpha) concentration in healthy women. METHODS Mid-trimester amniotic fluid samples from healthy women with a singleton pregnancy were obtained at the time of genetic amniocenteses. SDF-1alpha concentrations were determined by enzyme-linked immunosorbent assay. Maternal and neonatal characteristics were recorded. RESULTS A total of 210 samples were collected. According to the SDF-1alpha cutoff value established by the receiver operating characteristic curve analysis (< 6.42 vs. > or = 6.42 pg/mL), there was a trend toward higher preterm birth rate, lower birth weight and lower 1-minute and 5-minute Apgar scores when SDF-1alpha levels increased (p < 0.05). The pair comparison between normal and selected pregnancy disorders (gestational diabetes, pre-eclampsia, and abnormal placentation) showed no statistical significance (p > 0.05). Pearson's correlations of SDF-1alpha to gestational age at delivery (r = -0.151) and birth weight (r = -0.194) were significant (p < 0.05). In the multivariate analysis on mid-trimester SDF-1alpha levels, maternal age at sampling (regression coefficient = -0.163) and 1-minute Apgar score (< 7 vs. > or = 7, regression coefficient = 2.028) were both significant (p < 0.05). CONCLUSION Increased SDF-1alpha levels in mid-trimester amniotic fluid suggest a possible role in predicting pregnant women at risk of adverse neonatal outcomes including higher preterm birth rate, lower birth weight, and lower Apgar scores.