All issues > Volume 31(8); 1988

Original Article

J Korean Pediatr Soc. 1988;31(8):968-976. Published online August 31, 1988.

A Prospective Study of Urinary beta2 -Microglobulin in Infants with Meconium-Stained Amniotic Fluid.

Sung Oh Kim¹, Jeh Hoon Shin¹, Woo Gill Lee¹, Soo Jee Moon¹, Keun Soo Lee¹

¹Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea

Received: June 20, 1988;  Accepted: August 1, 1988.

Abstract

We studied prospectively whether events that result in meconium staining may be associated with additional abnormalities that are not clinically apparent associated by measurements of urinary concentrations of β₂-microglobulin indicating renal proximal tubular functions. Among 61 fullterm, healthy neonates delivered at Hanyang University Hospital during the period of September 1986 through April 1987, urinary concentration of β₂-microglobulin and creatinine were measured during the immediate perinatal period. Of these, 39 had meconium stained amniotic fluid; the remaining 22 had clear amniotic fluid. None of the infants or their mothers had conditions known to modify urinary β₂-microglobulin The following results were obtained: 1) Urinary β₂-microglobulin concentrations increased significantly in the normal infants (p< 0.002) from the 1st day (0.58±0.13 mg/L) to the 3rd day (1.39 ±0.21 mg/L) postpartum, also in the infants with meconium stained aminiotic fluid (p<0.014) from the 1st day (3.59±0.47 mg/L) to the 3rd day (5. 17 ±0.44 mg/L) postpartum. 2) Compared with the normal infants, values for the infants with meconium stained amniotic fluid were increased significantly both on day 1 and 3 postpartum (p< 0.0001). 3) Urinary creatinine levels were also declined from the 1st day to the 3rd day postpartum in both the normal infants and those with meconium stained amniotic fluid but compared with normal infants, values for the infant with meconium stained amniotid fluid were not increased significantly on day 1 and 3 postpartum. 4) Creatinine ratio for β₂-microglobulin were also increased significantly from the 1st day to the 3rd day postpartum both in the normal infants (1.85 ± 0;51->5.94 ± 1.02 /µg/mg, p< 0.001) and in the infants with the meconium stained amniotic fluid (6.94 ±0.83->15.34 ±1.53 µg/mg, p< 0.0001). Comparison between the normal infants and the infants with the meconium stained amniotic fluid were increased significantly on days 1 and 3 postpartum (p< 0.0001). 5) The elevated levels of urinary β₂-microglobulin in the infants with meconium stained amniotic fluid indicates the existence of renal tubular dysfunction.

Keywords :Urinary β₂-microglobulin, Renal proximal tubular dysfunction, Meconium-stained amniotic fluid