{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:09:11Z","timestamp":1791929351926,"version":"4.3.4"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>\n            Objective\u2003Cord gas values and Apgar scores, currently used as markers for newborn wellbeing and postpartum complications, provide rough estimates, and their use remains elusive. Circulating cell-free DNA (cfDNA) may better represent newborn status at birth and the effect of parturition on the fetus. This pilot study investigates the association between cord blood (CB) cfDNA and neonatal outcomes.<\/jats:p><jats:p>\n            Study Design\u2003In a prospective cohort study, cfDNA concentration was measured in immediately following delivery collected CB sera of newborns using our rapid fluorescent assay.<\/jats:p><jats:p>\n            Results\u2003During the study period, blood samples from umbilical cords of 100 newborns were collected. Vaginal delivery was associated with a higher median CB cfDNA than cesarean delivery (277 [95% confidence interval [CI] 199\u2013377] vs. 100 [95% CI 43\u2013265] ng\/mL, p\u2009&lt;\u20090.01). cfDNA levels were significantly associated with gestational age at delivery (rho\u2009=\u20090.308, p\u2009=\u20090.002) and CB base deficit (BD, r\u2009=\u20090.252, p\u2009=\u20090.017). According to maternal and fetal complications, CB cfDNA was elevated in fetuses with category II of heart rate tracing (p\u2009&lt;\u20090.05), with maternal positive vaginal culture (p\u2009&lt;\u20090.01), and with premature rupture of membranes (PROM, p\u2009&lt;\u20090.001). Logistic regression models of CB cfDNA fourth quartiles demostrate a double odds ratio for elevated BD (&gt;3mmol\/L) and for worse heart rate tracing category.<\/jats:p><jats:p>\n            Conclusion\u2003Serum CB cfDNA concentration reflects the newborn's status and hazards with an excellent association with CB BD, fetal heart rate category, and maternal risk factors for infection (positive vaginal culture and PROM). This preliminary observation suggests that cfDNA can serve as a point of care biomarker for newborn status at the time of delivery.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-1787-3838","type":"journal-article","created":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T23:59:55Z","timestamp":1646351995000},"page":"1027-1032","source":"Crossref","is-referenced-by-count":3,"title":["Cord Blood Cell-Free DNA Concentration: A Novel Marker for Neonatal Wellbeing"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7174-8591","authenticated-orcid":false,"given":"Majdi","family":"Imterat","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel"},{"name":"Department of Gynecology and Gynecologic Oncology, Ev. Kliniken Essen-Mitte, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Offer","family":"Erez","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, HaEmek Medical Center, Afula, Israel"},{"name":"Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Tirosh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael Miller","family":"Gelkop","sequence":"additional","affiliation":[{"name":"Department of Life Sciences, Faculty of Natural Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neta","family":"Benshalom-Tirosh","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry and Pharmacology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maor","family":"Ben-Tabo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Assuta Medical Center, Ashdod, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amos","family":"Douvdevani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Assuta Medical Center, Ashdod, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,6,6]]},"reference":[{"issue":"07","key":"ref1","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1016\/0002-9378(73)90066-5","article-title":"Fetal and neonatal biochemistry and Apgar scores","volume":"117","author":"H Modanlou","year":"1973","journal-title":"Am J Obstet Gynecol"},{"issue":"07","key":"ref2","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1111\/j.1471-0528.2012.03335.x","article-title":"The relationship between umbilical cord arterial pH and serious adverse neonatal outcome: analysis of 51,519 consecutive validated samples","volume":"119","author":"P Yeh","year":"2012","journal-title":"BJOG"},{"issue":"04","key":"ref3","first-page":"260","article-title":"A proposal for a new method of evaluation of the newborn infant","volume":"32","author":"V Apgar","year":"1953","journal-title":"Curr Res Anest Anal"},{"issue":"11","key":"ref4","doi-asserted-by":"crossref","first-page":"2409","DOI":"10.1097\/CCM.0000000000000509","article-title":"Delayed antimicrobial therapy increases mortality and organ dysfunction duration in pediatric sepsis","volume":"42","author":"S L Weiss","year":"2014","journal-title":"Crit Care Med"},{"issue":"06","key":"ref5","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1016\/S0002-9378(97)70080-2","article-title":"Threshold of metabolic acidosis associated with newborn complications","volume":"177","author":"J A Low","year":"1997","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1038\/nrc.2017.7","article-title":"Liquid biopsies come of age: towards implementation of circulating tumour DNA","volume":"17","author":"J CM Wan","year":"2017","journal-title":"Nat Rev Cancer"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1373\/clinchem.2007.101030","article-title":"Cell-free plasma DNA as a predictor of outcome in severe sepsis and septic shock","volume":"54","author":"K Saukkonen","year":"2008","journal-title":"Clin Chem"},{"issue":"05","key":"ref8","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1016\/j.surg.2017.06.015","article-title":"Cell-free deoxyribonucleic acid as a prognostic marker of bowel ischemia in patients with small bowel obstruction","volume":"162","author":"U Netz","year":"2017","journal-title":"Surgery"},{"issue":"09","key":"ref9","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1373\/clinchem.2006.084509","article-title":"Increased concentrations of antibody-bound circulatory cell-free DNA in rheumatoid arthritis","volume":"53","author":"X Y Zhong","year":"2007","journal-title":"Clin Chem"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1258\/acb.2009.009002","article-title":"A rapid direct fluorescent assay for cell-free DNA quantification in biological fluids","volume":"46","author":"H Goldshtein","year":"2009","journal-title":"Ann Clin Biochem"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1309\/AJCPI5YHG0OGFAHM","article-title":"Measurement of circulating cell-free DNA levels by a simple fluorescent test in patients with breast cancer","volume":"143","author":"R Agassi","year":"2015","journal-title":"Am J Clin Pathol"},{"issue":"06","key":"ref12","doi-asserted-by":"crossref","first-page":"e100514","DOI":"10.1371\/journal.pone.0100514","article-title":"Admission cell free DNA levels predict 28-day mortality in patients with severe sepsis in intensive care","volume":"9","author":"A Avriel","year":"2014","journal-title":"PLoS One"},{"issue":"07","key":"ref14","doi-asserted-by":"crossref","first-page":"e0200360","DOI":"10.1371\/journal.pone.0200360","article-title":"Maternal total cell-free DNA in preeclampsia and fetal growth restriction: Evidence of differences in maternal response to abnormal implantation","volume":"13","author":"T Rafaeli-Yehudai","year":"2018","journal-title":"PLoS One"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1097\/AOG.0b013e3181aef106","article-title":"ACOG Practice Bulletin No. 106: intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles","volume":"114","author":"American College of Obstetricians and Gynecologists","year":"2009","journal-title":"Obstet Gynecol"},{"issue":"01","key":"ref16","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1093\/clinchem\/43.1.215","article-title":"Evaluation of the newborn's blood gas status","volume":"43","author":"R T Brouillette","year":"1997","journal-title":"Clin Chem"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/S0891-5520(05)70347-0","article-title":"Pathogenesis of preterm labor and preterm premature rupture of membranes associated with intraamniotic infection","volume":"11","author":"R Gomez","year":"1997","journal-title":"Infect Dis Clin North Am"},{"issue":"06","key":"ref18","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1177\/1753425917719995","article-title":"Elevated levels of circulating cell-free DNA and neutrophil proteins are associated with neonatal sepsis and necrotizing enterocolitis in immature mice, pigs and infants","volume":"23","author":"D N Nguyen","year":"2017","journal-title":"Innate Immun"},{"issue":"08","key":"ref19","doi-asserted-by":"crossref","first-page":"e6572","DOI":"10.1371\/journal.pone.0006572","article-title":"The association between intrauterine inflammation and spontaneous vaginal delivery at term: a cross-sectional study","volume":"4","author":"M L Houben","year":"2009","journal-title":"PLoS One"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1787-3838.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T13:43:29Z","timestamp":1730814209000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1787-3838"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,3]]},"references-count":18,"journal-issue":{"issue":"08","published-online":{"date-parts":[[2024,5,20]]},"published-print":{"date-parts":[[2024,6]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1787-3838","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,3,3]]},"published":{"date-parts":[[2022,3,3]]}}}