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[分娩方式对初乳中A、G和M免疫球蛋白浓度的影响]

[Influence of type of delivery on A, G and M immunoglobulin concentration in maternal colostrum].

作者信息

Striker Gabriel A J, Casanova Lucy D, Nagao Aparecida Tiemi

机构信息

Perinatologia, Hospital do Servidor Público Estadual de São Paulo, Sao Paulo, SP.

出版信息

J Pediatr (Rio J). 2004 Mar-Apr;80(2):123-8.

Abstract

OBJECTIVE

To investigate the association between type of delivery and immunoglobulin concentration in maternal colostrum.

METHODS

We studied 82 women who were giving birth. Age was between 21 and 41 years, gestational age was 37 or more weeks and parity up to IV pregnancies. The women were in good nutritional condition and did not have any pregnancy or puerperium- associated diseases. The following aspects were also considered as inclusion criteria for the newborn: weight > or = 2,500 g, Apgar score > 7 in the first minute and exclusive breastfeeding until discharge from the nursery. The women were divided into three groups: A - vaginal delivery, B - caesarean section with labor and C - elective caesarean section. Colostrum was collected manually between 48 and 72 h after delivery. Immunoglobulins were dosed using the ELISA technique.

RESULTS

There were no differences between the three groups in terms of time of colostrum collection. The shorter the time of colostrum collection, the greater the concentration of immunoglobulin A. Primiparous women had higher concentrations of IgA and IgM in maternal colostrum than did multiparous women. The group submitted to caesarean section with labor had higher concentrations of IgA in maternal colostrum than did the normal delivery group. IgM and IgG concentrations in colostrum were not influenced by type of delivery.

CONCLUSION

The occurrence of labor together with surgical stress induce higher IgA concentrations in the colostrum of women submitted to caesarean section with labor.

摘要

目的

探讨分娩方式与初乳中免疫球蛋白浓度之间的关联。

方法

我们研究了82名分娩女性。年龄在21至41岁之间,孕周为37周或以上,妊娠次数最多为四次。这些女性营养状况良好,无任何妊娠或产褥期相关疾病。新生儿的以下方面也被视为纳入标准:体重≥2500克,出生后第一分钟阿氏评分>7分,且直至从育婴室出院一直进行纯母乳喂养。这些女性被分为三组:A组 - 阴道分娩,B组 - 临产剖宫产,C组 - 择期剖宫产。在分娩后48至72小时之间手动采集初乳。使用酶联免疫吸附测定技术检测免疫球蛋白。

结果

三组在初乳采集时间方面无差异。初乳采集时间越短,免疫球蛋白A的浓度越高。初产妇初乳中IgA和IgM的浓度高于经产妇。临产剖宫产组产妇初乳中IgA的浓度高于顺产组。初乳中IgM和IgG的浓度不受分娩方式影响。

结论

临产加上手术应激会使临产剖宫产女性初乳中的IgA浓度升高。

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