Key result
Early second-trimester amniotic fluid apelin concentrations were significantly lower in large for gestational age fetuses compared to appropriate for gestational age fetuses (14.35 vs 40.20 ng/mL, p=0.002).
Why the study?
Do apelin and insulin concentrations in early second-trimester amniotic fluid correlate with fetal growth disorders?
Cohort (n=80)
No
Do apelin and insulin concentrations in early second-trimester amniotic fluid correlate with fetal growth disorders?
Absolute Event Rate: 14.35% vs 40.2%
p-value: p=0.002
Amniotic fluid apelin concentrations in the early second trimester are lower in fetuses that become large for gestational age, suggesting potential utility as a predictive biomarker.
Amniotic fluid apelin should not yet guide clinical decisions; hypothesis-generating for LGA prediction and needs prospective validation.
INTRODUCTION: Fetal growth disturbances place fetuses at increased risk for perinatal morbidity and mortality. As yet, little is known about the basic pathogenetic mechanisms underlying deranged fetal growth. Apelin is an adipokine with several biological activities. Over the past decade, it has been investigated for its possible role in fetal growth restriction. Most studies have examined apelin concentrations in maternal serum and amniotic fluid in the third trimester or during neonatal life. In this study, apelin concentrations were examined for the first time in early second-trimester fetuses. Another major regulator of tissue growth and metabolism is insulin. MATERIALS AND METHODS: This was a prospective observational cohort study. We measured apelin and insulin concentrations in the amniotic fluid of 80 pregnant women who underwent amniocentesis in the early second trimester. Amniotic fluid samples were stored in appropriate conditions until delivery. The study groups were then defined, i.e., gestations with different fetal growth patterns (SGA, AGA, and LGA). Measurements were made using ELISA kits. RESULTS: = 0.007). Apelin concentrations in large for gestational age (LGA) fetuses were significantly lower compared to those in AGA and SGA fetuses. Insulin concentrations did not differ significantly among groups. CONCLUSIONS: A clear trend towards decreasing apelin concentrations as birthweight progressively increased was identified. Amniotic fluid apelin concentrations in the early second trimester may be useful as a predictive factor for determining the risk of a fetus being born LGA. Future studies are expected/needed to corroborate the present findings and should ideally focus on the potential interplay of apelin with other known intrauterine metabolic factors.
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Vrachnis et al. (2023) conducted a cohort in Fetal growth disorders (SGA, LGA) (n=80). Amniotic fluid apelin and insulin concentrations vs. Appropriate for gestational age (AGA) fetuses was evaluated on Amniotic fluid apelin concentration (ng/mL) (p=0.002). Early second-trimester amniotic fluid apelin concentrations were significantly lower in large for gestational age fetuses compared to appropriate for gestational age fetuses (14.35 vs 40.20 ng/mL, p=0.002).
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