The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2026
Clinical significance of soluble E-selectin and soluble vascular cell adhesion molecule-1 levels in umbilical cord blood for neonatal respiratory distress syndrome: a retrospective study.
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Huang Qiuxiang, Qin Yan
Аннотация
OBJECTIVE: This study evaluates the clinical significance of soluble E-selectin (sE-selectin) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in umbilical cord blood for neonatal respiratory distress syndrome (NRDS).
METHODS: This retrospective single-center study collected 558 preterm infants, categorized into NRDS (n = 162) and non-NRDS (n = 396) groups. sE-selectin and sVCAM-1 levels in umbilical cord blood were measured. Their correlations with the 5-minute Apgar score and PaO2/FiO2 ratio were assessed using Spearman/Pearson analysis. ROC curves were generated to assess their predictive value for NRDS diagnosis and discriminatory value for 28-day prognosis. Logistic and Poisson regression models were used to identify risk factors for poor prognosis.
RESULTS: sE-selectin and sVCAM-1 were elevated in NRDS infants and positively correlated with disease severity. They showed negative correlations with 5-minute Apgar score and PaO2/FiO2 ratio. For NRDS prediction, the AUC was 0.894 for sE-selectin and 0.878 for sVCAM-1. sE-selectin combined with sVCAM-1 achieved an AUC of 0.935. For discriminating poor 28-day prognosis, the AUC was 0.867 for sE-selectin and 0.878 for sVCAM-1. The combined AUC of 0.913 was higher than that of any biomarker alone. sE-selectin (OR: 1.163, 95%CI: 1.057 ∼ 1.279), sVCAM-1 (OR: 1.097, 95%CI: 1.035 ∼ 1.163), and 5-minute Apgar score (OR: 0.408, 95%CI: 0.269 ∼ 0.620) were independently associated with poor prognosis. Poisson regression analysis results in the generalized linear model were consistent with the conclusions of the logistic regression analysis.
CONCLUSION: sE-selectin and sVCAM-1 are elevated in umbilical cord blood in NRDS infants and closely correlated with disease severity and 28-day prognosis.
METHODS: This retrospective single-center study collected 558 preterm infants, categorized into NRDS (n = 162) and non-NRDS (n = 396) groups. sE-selectin and sVCAM-1 levels in umbilical cord blood were measured. Their correlations with the 5-minute Apgar score and PaO2/FiO2 ratio were assessed using Spearman/Pearson analysis. ROC curves were generated to assess their predictive value for NRDS diagnosis and discriminatory value for 28-day prognosis. Logistic and Poisson regression models were used to identify risk factors for poor prognosis.
RESULTS: sE-selectin and sVCAM-1 were elevated in NRDS infants and positively correlated with disease severity. They showed negative correlations with 5-minute Apgar score and PaO2/FiO2 ratio. For NRDS prediction, the AUC was 0.894 for sE-selectin and 0.878 for sVCAM-1. sE-selectin combined with sVCAM-1 achieved an AUC of 0.935. For discriminating poor 28-day prognosis, the AUC was 0.867 for sE-selectin and 0.878 for sVCAM-1. The combined AUC of 0.913 was higher than that of any biomarker alone. sE-selectin (OR: 1.163, 95%CI: 1.057 ∼ 1.279), sVCAM-1 (OR: 1.097, 95%CI: 1.035 ∼ 1.163), and 5-minute Apgar score (OR: 0.408, 95%CI: 0.269 ∼ 0.620) were independently associated with poor prognosis. Poisson regression analysis results in the generalized linear model were consistent with the conclusions of the logistic regression analysis.
CONCLUSION: sE-selectin and sVCAM-1 are elevated in umbilical cord blood in NRDS infants and closely correlated with disease severity and 28-day prognosis.