Lurie Samuel, Matas Zippora, Boaz Mona, Fux Asora, Golan Abraham, Sadan Oscar
Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel.
Neonatology. 2007;92(2):111-5. doi: 10.1159/000100965. Epub 2007 Mar 21.
Several studies have addressed the influence of labor and mode of delivery on oxidative stress. Still it is unclear whether oxidative stress is related to delivery itself or whether it reflects a pre-existing fetal oxidative status.
To investigate whether the degree of fetal oxidative stress is different between distressed fetuses that were delivered by emergent cesarean section and non-distressed fetuses that were delivered by elective cesarean section.
The protocol of this prospective study was approved by the Institutional Review Board Committee. Amniotic fluid and umbilical artery blood were prospectively collected from 21 parturients who were delivered by an emergent cesarean section for non-reassuring fetal heart rate pattern and from 21 parturients who were delivered by an elective cesarean section in a tertiary care center. Oxidative stress was evaluated in amniotic fluid, umbilical cord plasma and erythrocytes by determining malondialdehyde concentration and glutathione peroxidase (GPX) activity.
Malondialdehyde concentration was higher in amniotic fluid (mean +/- SEM) (2.2 +/- 0.7 nmol/l vs. 0.6 +/- 0.02 nmol/l, p < 0.05), in umbilical cord plasma (1.2 +/- 0.2 nmol/l vs. 0.7 +/- 0.3 nmol/l, p < 0.05) and in umbilical cord erythrocytes (159.6 +/- 48.6 nmol/g Hb vs. 85.8 +/- 5.2 nmol/g Hb, p < 0.05) in women delivering by emergent cesarean compared to those delivering by elective cesarean. GPX activity was enhanced in amniotic fluid (12.4 +/- 2.2 U/l vs. 5.1 +/- 0.6 U/l, p < 0.05) and GPX activity/hemoglobin ratio was higher in cord blood (22.0 +/- 0.8 U/g Hb vs. 18.7 +/- 0.9 U/g Hb, p < 0.05) in women delivering by emergent cesarean compared to those delivering by elective cesarean.
Distressed fetuses delivered by emergency cesarean exhibited increased malondialdehyde concentrations, an indicative parameter for oxidative damage, and enhanced GPX activity an antioxidant enzyme, in amniotic fluid and umbilical cord blood compared to non-distressed fetuses delivered by elective cesarean section. This is probably an indication of higher fetal oxidative stress.
多项研究探讨了分娩及分娩方式对氧化应激的影响。然而，尚不清楚氧化应激是与分娩本身相关，还是反映了胎儿先前已存在的氧化状态。
研究紧急剖宫产分娩的窘迫胎儿与择期剖宫产分娩的非窘迫胎儿之间，胎儿氧化应激程度是否存在差异。
本前瞻性研究方案经机构审查委员会批准。前瞻性收集了在三级医疗中心因胎儿心率异常而行紧急剖宫产的21名产妇的羊水和脐动脉血，以及择期剖宫产的21名产妇的羊水和脐动脉血。通过测定丙二醛浓度和谷胱甘肽过氧化物酶（GPX）活性，评估羊水中、脐血浆和红细胞中的氧化应激情况。
与择期剖宫产的产妇相比，紧急剖宫产的产妇羊水中丙二醛浓度更高（平均±标准误）（2.2±0.7 nmol/l对0.6±0.02 nmol/l，p<0.05），脐血浆中丙二醛浓度更高（1.2±0.2 nmol/l对0.7±0.3 nmol/l，p<0.05），脐血红细胞中丙二醛浓度更高（159.6±48.6 nmol/g血红蛋白对85.8±5.2 nmol/g血红蛋白，p<0.05）。与择期剖宫产的产妇相比，紧急剖宫产的产妇羊水中GPX活性增强（12.4±2.2 U/l对5.1±0.6 U/l，p<0.05），脐血中GPX活性/血红蛋白比值更高（22.0±0.8 U/g血红蛋白对18.7±0.9 U/g血红蛋白，p<0.05）。
与择期剖宫产分娩的非窘迫胎儿相比，紧急剖宫产分娩的窘迫胎儿羊水中丙二醛浓度升高（氧化损伤的指示参数），脐血中抗氧化酶GPX活性增强。这可能表明胎儿氧化应激水平更高。
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