Zeitschrift fur Geburtshilfe und Neonatologie · 2026
Diagnostic Value of Maternal Zonulin Levels in Fetal Growth Disorders.
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Çelik Samettin, Urkmez Sebati Sinan, Civil Ürkmez Yeşim
Аннотация
BACKGROUND: Zonulin, a biomarker linked to intestinal barrier dysfunction, may contribute to fetal growth disorders such as intrauterine growth restriction (IUGR) and small-for-gestational-age (SGA) pregnancies. This study evaluated maternal serum zonulin levels as a diagnostic tool for distinguishing IUGR from SGA and investigated their associations with perinatal outcomes.
METHODS: This cross-sectional study included singleton pregnancies between 32 and 37 weeks. Maternal blood samples collected at 16-18 weeks of gestation were analyzed for serum zonulin levels using ELISA, with measurements performed after group classification based on the final diagnosis (IUGR, SGA, and appropriate-for-gestational-age [AGA]). Demographic, obstetric, and neonatal data were analyzed. Diagnostic performance was assessed via receiver operating characteristic (ROC) curve analysis.
RESULTS: Maternal serum zonulin levels were highest in the IUGR group, followed by SGA and AGA (p<0.001). The optimal cutoff for diagnosing IUGR was 15.70 ng/mL, with a sensitivity of 86.7% and specificity of 62.5% (AUC: 0.779). For distinguishing IUGR from SGA, the cutoff was 20.28 ng/mL (sensitivity: 71.7%, specificity: 73.3%, AUC: 0.748). Zonulin levels negatively correlated with birth weight, gestational age, and Apgar scores (p< 0.05).
CONCLUSION: Maternal serum zonulin shows significant diagnostic potential for identifying IUGR and distinguishing it from SGA pregnancies. These findings suggest that zonulin could serve as a biomarker for pathological fetal growth restriction, warranting further studies to confirm its clinical utility.
METHODS: This cross-sectional study included singleton pregnancies between 32 and 37 weeks. Maternal blood samples collected at 16-18 weeks of gestation were analyzed for serum zonulin levels using ELISA, with measurements performed after group classification based on the final diagnosis (IUGR, SGA, and appropriate-for-gestational-age [AGA]). Demographic, obstetric, and neonatal data were analyzed. Diagnostic performance was assessed via receiver operating characteristic (ROC) curve analysis.
RESULTS: Maternal serum zonulin levels were highest in the IUGR group, followed by SGA and AGA (p<0.001). The optimal cutoff for diagnosing IUGR was 15.70 ng/mL, with a sensitivity of 86.7% and specificity of 62.5% (AUC: 0.779). For distinguishing IUGR from SGA, the cutoff was 20.28 ng/mL (sensitivity: 71.7%, specificity: 73.3%, AUC: 0.748). Zonulin levels negatively correlated with birth weight, gestational age, and Apgar scores (p< 0.05).
CONCLUSION: Maternal serum zonulin shows significant diagnostic potential for identifying IUGR and distinguishing it from SGA pregnancies. These findings suggest that zonulin could serve as a biomarker for pathological fetal growth restriction, warranting further studies to confirm its clinical utility.