BRIEF RESEARCH REPORT article
Front. Pediatr.
Sec. Neonatology
Amniotic Fluid Neutrophil Gelatinase-Associated Lipocalin and L-Type Fatty Acid-Binding Protein Levels in Predicting Long-Term Prognosis in Fetal Growth Restriction and Preterm Birth: A Preliminary Study
Provisionally accepted
Daisuke Katsura1,2*
Shunichiro Tsuji1,2
Shinsuke Tokoro1,2Ayako Inatomi1,2Nobuyuki Kita1,2Takashi Murakami1,2- 1Shiga University of Medical Science, Otsu, Japan
- 2Shiga Ika Daigaku Igakubu Fuzoku Byoin, Otsu, Japan
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Introduction: The fetal intrauterine environment, including inflammation and fetal hypoxia, influences both short-and long-term prognoses. Urinary neutrophil gelatinase-associated lipocalin (NGAL) and L-type fatty acid-binding protein (L-FABP) levels are associated with inflammation and organ hypoperfusion, respectively. In this study, we evaluated the association between amniotic fluid NGAL and L-FABP levels measured at delivery and long-term outcomes. Methods: Adverse outcomes were defined as hearing loss, neurodevelopmental impairment, and cerebral palsy. Thirty-one singleton pregnancies were categorized into groups with (AD group, n=10) and without (non-AD group, n=21) adverse outcomes. Patient characteristics, clinical outcomes, and NGAL and L-FABP levels were compared between groups. Results: Significant differences in the prevalence of fetal blood flow abnormalities (p=0.003) and gestational age at delivery (p=0.004) were observed between groups. NGAL and L-FABP levels were significantly higher in the AD group than in the non-AD group (p=0.015 and p=0.001, respectively). The areas under the curve for NGAL and L-FABP were 0.771 (cut-off: 26,700 µg/gCr) and 0.848 (cut-off: 1,250 µg/gCr), respectively. Discussion: Amniotic fluid NGAL and L-FABP levels were associated with adverse long-term outcomes, providing preliminary, proof-of-concept evidence of their potential prognostic relevance. Further prospective studies with larger cohorts are needed to validate these findings and clarify their clinical applicability.
Keywords: Amniotic Fluid, Infant Mortality, Long-term prognosis, L-type fatty acid-binding protein, neonatal mortality, Neutrophil gelatinase-associated lipocalin
Received: 24 Sep 2025; Accepted: 10 Dec 2025.
Copyright: © 2025 Katsura, Tsuji, Tokoro, Inatomi, Kita and Murakami. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Daisuke Katsura
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