Abstract
Intrauterine growth retardation (IUGR) is thought to reflect suppression of genetic growth potential by decreased supplies of oxygen and substrate (1). NO supplementation may be useful in IUGR to increase uteroplacental circulation (2)(3)(4)(5). The use of biochemical markers to assess the extent of brain distress associated with NO treatment could be appropriate. S100B is an acidic calcium-binding protein of the EF-hand family concentrated in the nervous system (6). The appearance of S100B in biological fluids is an indicator of brain distress in both infants and adults (7)(8)(9)(10). Recently, blood S100B concentrations in the perinatal period have been shown to correlate with brain maturation and damage (11)(12)(13)(14). We investigated the effect of maternal NO supplementation on brain distress in IUGR fetuses as assessed by cord blood S100B. We selected 51 pregnant women (gestational age, 27–35 weeks) with IUGR fetuses and impaired uteroplacental blood flow. Exclusion criteria included multiple pregnancies, gestational and type 1 diabetes, maternal infections and fever, fetal malformations and chromosomal abnormalities, metabolic diseases, and maternal diseases of the central nervous system. Patients were assigned, by use of computer-generated random numbers, to receive either placebo (n = 25) or transdermal glyceryl trinitrate (Nitroderm TTS; Ciba-Geigy) at a dose of 5 mg/16 h daily until delivery (n = 26). Placebo and glyceryl trinitrate patches were indistinguishable and were numbered and contained in identical envelopes so that patients did not know the group to which they were recruited. Similarly, neither the physicians nor the investigators who analyzed the samples knew which patients were treated with placebo and which with glyceryl trinitrate patches. The local ethics committee approved the study, and written informed consent was obtained from all participants. Two patients in the glyceryl …
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