Abstract

BackgroundSulfate is important for fetal growth and development. During pregnancy, the fetus relies on sulfate from the maternal circulation. We report reference intervals for maternal plasma sulfate levels and fractional excretion index (FEI) for sulfate in pregnancy, as well as sulfate levels in cord blood from term pregnancies.MethodsPlasma and urine were collected from 103 pregnant women of 10-20 weeks gestation and 106 pregnant women of 30-37 weeks gestation. Venous cord plasma was collected from 80 healthy term babies. Sulfate levels were measured by ion chromatography. Plasma and urinary creatinine levels were used to calculate FEI sulfate in pregnant women. Analyses provide reference intervals, and explored the relationship between maternal sulfate data with several prenatal factors.ResultsMedian maternal plasma sulfate levels were 452 μmol/L and 502 μmol/L at 10-20 and 30-37 weeks gestation, respectively, and inversely correlated with FEI sulfate median values of 0.15 and 0.11. Overall reference intervals were 305-710 and 335-701 μmol/L (2.5th; 97.5th percentile; for 10-20 and 30-37 weeks gestation, respectively) for maternal plasma sulfate, and 0.06-0.31 and 0.05-0.28 for maternal FEI sulfate. Term venous cord plasma sulfate median levels were significantly (p = 0.038) higher in female babies (375 μmol/L) when compared to male babies (342 μmol/L), with an overall reference interval of 175-603 μmol/L.ConclusionsWe provide the first reference intervals for maternal plasma sulfate levels and FEI sulfate, as well as cord plasma sulfate levels. These findings provide reference data for further studies of sulfate levels in both mother and child.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-015-0526-z) contains supplementary material, which is available to authorized users.

Highlights

  • Sulfate is important for fetal growth and development

  • In this paper we report reference intervals for maternal plasma sulfate levels and fractional excretion index (FEI) sulfate in early and late human gestation, as well as venous cord plasma sulfate levels in term infants

  • We provide the first set of reference intervals for maternal plasma sulfate and FEI sulfate in early and late gestation, and for term venous cord plasma sulfate, using a validated sulfate test

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Summary

Introduction

The fetus relies on sulfate from the maternal circulation. More than 20 genes involved in maintaining the required biological ratio of sulfonated and unconjugated molecules have been linked to pathophysiologies in humans and animals [12]. Genes encoding sulfatases, which mediate the removal of sulfate from proteoglycans or lipids, are linked to several lysosomal storage diseases, including metachromatic leukodystrophy, Maroteaux-Lamy syndrome, Morquio A syndrome, Sanfilippo A and D syndromes and Hunter syndrome [13]. The SLC26A2 gene which mediates sulfate transport into chondrocytes for the sulfonation of chondroitin proteoglycan, is linked to four types of chondrodysplasias: multiple epiphyseal dysplasia (MEM), diastrophic dysplasia (DTD), atelosteogenesis Type II (AO2) and achondrogenesis Type IB (ACG1B) [14]

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