Objectives To document the maternal and fetal cord blood levels of human epididymis protein 4 (HE-4) in term and preterm newborns in order to investigate the possible physiological role of HE-4 in fetal lung development. Methods This cross-sectional study was conducted in a university-affiliated hospital between April 2018 and September 2018. The study population consisted of cesarean section (C-section) deliveries after 24 weeks of pregnancy. Both maternal and umbilical cord HE-4 levels (mHE-4 and uHE-4, respectively) were measured using chemiluminescent microparticle immunoassay. Amniotic fluid was sampled from each case to determine the lamellar body count (LBC) as the gold standard test for lung maturation. All the parameters, including the uHE-4 levels, were compared between the term delivery (≥37 weeks) (n=52) and preterm delivery (24–37th weeks) (n=30) groups. The best cut-off value of uHE-4 was calculated for fetal lung maturity. Results There were no statistically significant differences between the groups regarding the demographic data. The mHE-4 levels did not statistically significantly differ between the groups (p>0.05) whereas the uHE-4 level of the preterm newborns was significantly higher than that of the term newborns (p<0.05). There was a significant negative association between the uHE-4 level and LBC (r=−0.389; p<0.001). The uHE-4 level was the only statistically significant fetal parameter indicating fetal lung maturity confirmed by LBC. At a cut-off value of 281 pmol/L, uHE-4 had 96.8% sensitivity, 45% specificity, 84.5% positive predictive value, and 81.8% negative predictive value for fetal lung maturity. Conclusions Although the exact physiological role of HE-4 has not yet been elucidated, this preliminary study supports the idea that HE-4 plays a role in fetal lung maturation to some extent.

中文翻译：

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人附睾蛋白4与胎肺成熟度

目的 记录足月和早产新生儿母体和胎儿脐血中人附睾蛋白4（HE-4）的水平，以探讨HE-4在胎儿肺发育中可能的生理作用。方法 这项横断面研究于 2018 年 4 月至 2018 年 9 月在一家大学附属医院进行。研究人群包括怀孕 24 周后进行剖宫产（C-section）分娩。使用化学发光微粒免疫测定法测量母体和脐带 HE-4 水平（分别为 mHE-4 和 uHE-4）。从每个病例中取样​​羊水以确定板层体计数（LBC）作为肺成熟的金标准测试。所有参数，包括 uHE-4 级别，在足月分娩（≥37周）（n = 52）和早产（24-37周）（n = 30）组之间进行比较。uHE-4 的最佳截止值是针对胎肺成熟度计算的。结果在人口统计数据方面，各组之间没有统计学上的显着差异。组间mHE-4水平差异无统计学意义（p>0.05），而早产儿uHE-4水平显着高于足月儿（p<0.05）。uHE-4 水平与 LBC 之间存在显着的负相关（r=-0.389；p<0.001）。uHE-4 水平是唯一具有统计学意义的胎儿参数，表明 LBC 证实的胎肺成熟度。在 281 pmol/L 的临界值下，uHE-4 的敏感性为 96.8%，特异性为 45%，阳性预测值为 84.5%，阳性预测值为 81。胎肺成熟的阴性预测值为 8%。结论 虽然 HE-4 的确切生理作用尚未阐明，但这项初步研究支持 HE-4 在一定程度上促进胎儿肺成熟的观点。