Abstract
Background and Objectives: Fetal growth restriction (FGR) is a severe obstetric disease characterized by a low fetal size entailing a set of undesired consequences. For instance, previous studies have noticed a worrisome association between FGR with an abnormal neurodevelopment. However, the precise link between FGR and neurodevelopmental alterations are not yet fully understood yet. Brain-derived neurotrophic factor (BDNF) is a critical neurotrophin strongly implicated in neurodevelopmental and other neurological processes. In addition, serum levels of BDNF appears to be an interesting indicator of pathological pregnancies, being correlated with the neonatal brain levels. Therefore, the aim of this study is to analyze the blood levels of BDNF in the cord blood from fetuses with FGR in comparison to those with weight appropriate for gestational age (AGA). Materials and Methods: In this study, 130 subjects were recruited: 91 in group A (AGA fetuses); 39 in group B (16 FGR fetuses with exclusively middle cerebral artery (MCA) pulsatility index (PI) < 5th percentile and 23 with umbilical artery (UA) PI > 95th percentile). Serum levels of BDNF were determined through ELISA reactions in these groups. Results: Our results show a significant decrease in cord blood levels of BDNF in FGR and more prominently in those with UA PI >95th percentile in comparison to AGA. FGR fetuses with exclusively decreased MCA PI below the 5th percentile also show reduced levels of BDNF than AGA, although this difference was not statistically significant. Conclusions: Overall, our study reports a potential pathophysiological link between reduced levels of BDNF and neurodevelopmental alterations in fetuses with FGR. However, further studies should be conducted in those FGR subjects with MCA PI < 5th percentile in order to understand the possible implications of BDNF in this group.
Highlights
Fetal growth restriction (FGR) is a severe complication in pregnancy
Our sample consisted of 130 subjects: 91 in group A (AGA fetuses); 39 in group B
Brain-derived neurotrophic factor (BDNF) concentration in FGR fetuses with decreased MCA pulsatility index (PI) exclusively did not differ from the other fetuses, either appropriate for gestational age (AGA) or FGR, with UA PI > 95th percentile
Summary
Fetal growth restriction (FGR) is a severe complication in pregnancy. It monopolizes great resources of maternal fetal research, and though clearly stated in some guidelines [1], inconsistency in terminology and definition hampers interpretation and comparison of studies. The progression of FGR has been previously described and undergoes several hemodynamic phases, passing through a decrease in the estimated fetal weight centile below 10, followed by decreased pulsatility index (PI) in MCA and later, an elevation of the umbilical PI until reaching the final phase that is the alteration of the ductus venosus [5]. These stages have been related to postnatal neurodevelopment [6]. FGR fetuses with exclusively decreased MCA PI below the 5th percentile show reduced levels of BDNF than AGA, this difference was not statistically significant
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