Elevated Amniotic Fluid Stromal Cell-derived Factor-1α (SDF-1α) Concentration in Mid-gestation as a Predictor of Adverse Birth Outcomes

BackgroundThis study aimed to predict maternal and neonatal outcomes by measuring mid-trimester amniotic fluid stromal cell-derived factor-1α (SDF-1α) concentration in healthy women.MethodsMid-trimester amniotic fluid samples from healthy women with a singleton pregnancy were obtained at the time of genetic amniocenteses. SDF-1α concentrations were determined by enzyme-linked immunosorbent assay. Maternal and neonatal characteristics were recorded.ResultsA total of 210 samples were collected. According to the SDF-1α cutoff value established by the receiver operating characteristic curve analysis (< 6.42 vs. ≥ 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-1α 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-1α 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-1α levels, maternal age at sampling (regression coefficient = −0.163) and 1-minute Apgar score (< 7 vs. ≥ 7, regression coefficient = 2.028) were both significant (p < 0.05).ConclusionIncreased SDF-1α 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.