Cosar Hese, Ozer Erdener, Topel Hande, Kahramaner Zelal, Turkoglu Ebru, Erdemir Aydin, Sutcuoglu Sumer, Bagriyanik Alper, Ozer Esra Arun
Tepecik Training and Research Hospital, Neonatology Clinic, Yenisehir, Izmir, Turkey.
J Matern Fetal Neonatal Med. 2013 Jul;26(11):1143-6. doi: 10.3109/14767058.2013.770463. Epub 2013 Mar 6.
Preeclampsia may result in uteroplacental insufficiency and chronic intrauterine fetal distress. The aim of this study is to address this issue investigating neuronal apoptosis in an experimental model of preeclampsia and to evaluate the neurological outcome of the perinatal asphyxia in the neonates born to preeclamptic mother.
Two out of four pregnant Sprague-Dawley rats (preeclamptic group) were given water containing 1.8% NaCl on gestation day 15 and 22 in order to establish the model of preeclampsia whereas other two (non-preeclamptic group) received normal diet. A model of perinatal asphyxia was established on the postnatal 7th day to one preeclamptic and one non-preeclamptic dam. Overall 23 pups born to overall four dams were decapitated to assess neuronal apoptosis by the TUNEL assay.
The number of apoptotic neuronal cells was significantly higher in the preeclampsia groups in comparison with the control group (p = 0.006 and p = 0.006, respectively). It was also significantly higher in the asphyctic/non-preeclamptic group than the count in the control group (p = 0.01). There was also significant difference between both asphyctic groups (p = 0.003).
We conclude that preeclampsia causes small babies for the gestational age and cerebral hypoplasia. Both preeclampsia and perinatal asphyxia can cause increased neuronal apoptosis in the neonatal brains. However, the prognosis for neurological outcome is much worse when the perinatal asphyxia occurs in newborns born to preeclamptic mothers.
子痫前期可能导致子宫胎盘功能不全和慢性宫内胎儿窘迫。本研究旨在通过子痫前期实验模型研究神经元凋亡来解决这一问题,并评估子痫前期母亲所生新生儿围产期窒息的神经学结局。
四只怀孕的斯普拉格-道利大鼠中,两只(子痫前期组)在妊娠第15天和第22天给予含1.8%氯化钠的水以建立子痫前期模型,而另外两只(非子痫前期组)给予正常饮食。在出生后第7天,对一只子痫前期母鼠和一只非子痫前期母鼠建立围产期窒息模型。对总共四只母鼠所生的23只幼崽断头,通过TUNEL法评估神经元凋亡。
子痫前期组凋亡神经元细胞数量与对照组相比显著更高(分别为p = 0.006和p = 0.006)。窒息/非子痫前期组的凋亡神经元细胞数量也显著高于对照组(p = 0.01)。两组窒息组之间也存在显著差异(p = 0.003)。
我们得出结论,子痫前期导致小于胎龄儿和脑发育不全。子痫前期和围产期窒息均可导致新生儿脑内神经元凋亡增加。然而,当围产期窒息发生在子痫前期母亲所生新生儿时,神经学结局的预后要差得多。