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To assess the induction of autophagy in the human umbilical cord for physiological adaptation against starvation. The expression of autophagy-related proteins (LC3-II, p62) in umbilical cord tissues from 40 neonates was assessed by Western blotting. The correlation between the expression of autophagy-related proteins and maternal findings (height, weight, body mass index [BMI]), placental weight, neonatal findings (gestational age, height, weight, Apgar score at 1 min and 5 min), and the pH of the umbilical arterial blood were analyzed using Spearman’s rank correlation coefficient test ( p  values of &lt;.05 were considered significant). Venous blood findings (pH, pCO 2 , glucose, total protein, albumin, and lactic acid) were also evaluated in 16 neonates admitted to the NICU. The expression of LC3-II was positively correlated with serum total protein ( ρ  = 0.564,  p  = .023). The p62 level was also correlated with maternal BMI ( ρ  = 0.376,  p  = .017), the neonatal Apgar score at 1 min ( ρ  = 0.331  p  = .037), total protein ( ρ  = 0.588,  p  = .017), and albumin ( ρ  = 0.552,  p  = .027) positively. A multiple linear regression analysis that included clinical parameters related to fetal nutrition and neonatal growth revealed that serum total protein was significantly associated with both LC3-II ( p  = .024) and p62 ( p  = .034) in the umbilical cord. The LC3-II or p62 expression in the umbilical cord may suggest the autophagy reaction for the homeostasis of protein or amino acid metabolism in the perinatal period.

The autophagy reaction in the human umbilical cord: a potential marker for estimating fetal nutrition and neonatal growth