PEDIATRICS Vol. 76 No. 6 December 1985, pp. 958-964
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Urinary beta2-Microglobulin in Full-Term Newborns: Evidence for Proximal Tubular Dysfunction in Infants With Meconium-Stained Amniotic Fluid

J. W. Cole MD1, R. J. Portman MD1, Y. Lim 1, J. M. Perlman MD1, and A. M. Robson MD, FRCP1

1 From the Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, and the Divisions of Nephrology and Neonatology, St Louis Children's Hospital, St Louis

Urinary concentrations of beta2-microglobulin (beta2M) and creatinine were measured in normal term infants and in those born with meconium-stained amniotic fluid. None of the infants or their mothers had conditions known to modify beta2M excretion. Measurements of beta2M were made on urines collected by bagging; urines obtained from diapers were not satisfactory. Urinary beta2M concentrations increased significantly (P < .02) in the normal infants from the first day (0.36 ± 0.29 mg/L: n = 29) to the third day (0.60 ± 0.43 mg/L: n = 21) postpartum. Compared with the normal infants, values for the infants with meconium-stained amniotic fluid were increased significantly on days 1 (1.64 ± 2.16 mg/L: n = 25: P < .005) and 3 (2.12 ± 2.04 mg/L: n = 23: P < .005). Levels exceeded two standard deviations above the normal mean in 12 of the 26 infants with meconium-stained amniotic fluid on postpartum day 1, and 12 of the 23 infants with meconium-stained amniotic fluid on day 3. Urinary creatinine levels were similar in both the normal infants and those with meconium-stained amniotic fluid. All infants with meconium-stained amniotic fluid with a one-minute Apgar score of 6 or less had an elevated urinary beta2M concentration. The elevated levels of urinary beta2M in infants with meconium-stained amniotic fluid indicate the existence of tubular dysfunction, probably mild acute tubular necrosis secondary to hypoxia.

Key Words: urinary beta2-microglobulin • newborn • kidney • proximal tubule • meconium-stained amniotic fluid

Submitted on December 10, 1984
Accepted on March 19, 1985




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