Impact of intrapartum factors on oxidative stress in newborns.

OBJECTIVE

To determine the impact of the method of delivery and type of obstetric anesthesia on oxidative stress in neonates.

METHODS

The trial included 164 women in two groups of elective cesarean delivery (CD) and uncomplicated vaginal delivery (VD) at term. The CD group was randomized to either a spinal or general anesthesia and the VD group was randomized to either a local or a spinal saddle block. The main outcome measures were the umbilical venous blood glutathione and malondialdhyde (MDA).

RESULTS

Neonates of CD had significantly higher levels of MDA and pO(2) and lower glutathione levels than VD. However, in regression analysis, the mode of delivery and type of anesthesia were independent factors that determine the level of MDA but not the level of glutathione. Gestational age was a significant predictor of the glutathione level while birth weight was a significant predictor of the MDA level.

CONCLUSION

The oxidative status of the newborn is not simply a reflection of the mode of delivery and type of anesthesia. The impact of gestational age and birth weight appears to be crucial. This must be considered when planning elective delivery.