Genç ŞÖ, Karakuş S, Çetin A, Çetin M, Doğan HO, Ünver Korgalı E. Serum Bcl-2, caspase-9 and soluble FasL levels as perinatal markers in late preterm pregnancies with intrauterine growth restriction. Turk J Pediatr 2019; 61: 686-696. Intrauterine growth restriction (IUGR) is the inability of the fetus to grow and develop in the expected pattern. It occurs in about 5% of pregnancies and is associated with severe fetal mortality and morbidity. Affected infants are also highly vulnerable to diseases such as perinatal asphyxia, cerebral palsy, meconium aspiration syndrome, coagulation disorders, and immune system disorders that require long-term treatment. Apoptosis is thought to play a key role in the etiopathogenesis of IUGR. In conclusion, fetal complications are thought to be related to the severity of apoptosis in pregnancies complicated with IUGR. The aim of the study was to test the measurability of the severity of apoptosis using Bcl-2, caspase-9, soluble Fas ligand (sFasL) markers and the maternal blood sample in addition to the diagnostic methods commonly used to diagnose IUGR; and to decrease the rates of adverse perinatal outcomes due to IUGR and to evaluate the fetal well-being status without feeling a need for invasive procedures. One hundred and fifty-nine late preterm pregnancies were included in the study. Eighty were diagnosed with IUGR and the others were the control group. During delivery, maternal and umbilical cord blood samples were taken. Bcl-2, caspase-9, sFasL marker levels in maternal and umbilical cord sera were determined using ELISA method. Bcl-2 levels were found to be significantly high in the maternal and umbilical cord sera in the IUGR group. There was also no significant difference between umbilical cord sera of the two groups in terms of sFasL and caspase-9 levels. The results suggest that maternal serum Bcl-2 levels may also be helpful in the diagnosis of IUGR when used besides the ultrasonographic findings. Multicenter studies with large patient groups will increase knowledge in this area.
Keywords: Bcl-2; Late preterm birth; caspase-9; intrauterine growth restriction; soluble Fas ligand.