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足月儿的硒状态,根据出生体重和胎龄,与母亲高血压病理情况的关系。

Selenium status in term neonates, according to birth weight and gestational age, in relation to maternal hypertensive pathology.

作者信息

Bizerea-Moga Teofana Otilia, Pitulice Laura, Bizerea-Spiridon Otilia, Angelescu Claudiu, Mărginean Otilia, Moga Tudor Voicu

机构信息

Department XI of Pediatrics-1st Pediatric Discipline, Center for Research on Growth and Developmental Disorders in Children, "Victor Babeș" University of Medicine and Pharmacy Timișoara, Timișoara, Romania.

1st Pediatric Clinic, "Louis Țurcanu" Children's Clinical and Emergency Hospital, Timișoara, Romania.

出版信息

Front Pediatr. 2023 Mar 30;11:1157689. doi: 10.3389/fped.2023.1157689. eCollection 2023.

Abstract

BACKGROUND

Pregnancy represents a state of increased oxidative stress and antioxidants, in which selenium (Se) plays a pivotal role, contribute to maintain the oxidative balance. If antioxidant defenses are depleted, placental function is disrupted, resulting in pregnancy complications, including pregnancy-induced hypertension (PIH). Little is known about fetal selenium status in concomitant relation to maternal PIH, gestational age (GA) and birthweight (BW).

METHODS

We examined over a 3-year period the serum (SeS) and urine selenium (SeU) status in term neonates from normotensive (nonPIH) and hypertensive (PIH) mothers as clinical markers of oxidative stress. In this retrospective observational study, 72 neonates with maternal PIH were matched for GA and BW to 72 neonates of normotensive mothers. Four groups were obtained, based on maternal PIH and BW relative to GA (appropriate-for-gestational-age-AGA, small-for-gestational-age-SGA): nonPIH-AGA (control group), nonPIH-SGA, PIH-AGA, and PIH-SGA.

RESULTS

The results showed significant differences ( < 0.001) in selenium levels among the study groups: SeS - 44.85 ± 7.56 μg/L in nonPIH-AGA, 39.62 ± 11.42 μg/L in nonPIH-SGA, 40.01 ± 10.07 μg/L in PIH-AGA, and 25.39 ± 8.99 μg/L in PIH-SGA; SeU - 27.98 ± 7.99 μg/L in nonPIH-AGA, 22.85 ± 9.48 μg/L in nonPIH-SGA, 23.44 ± 6.73 μg/L in PIH-AGA, and 13.05 ± 5.86 μg/L in PIH-SGA. Selenium depletion was more common in neonates born from hypertensive mothers and those born small for gestational age. Though moderate in intensity, selenium levels were positively correlated with BW (0.319 for SeS, 0.397 for SeU) and negatively correlated with maternal systolic blood pressure (-0.313 for SeS, -0.324 for SeU). The main independent effects on SeS and SeU of each maternal blood pressure and birth weight turned out statistically significant. In interaction, a more pronounced effect was reached in PIH-SGA neonates.

CONCLUSION

Selenium status seemed to reflect the negative impact that PIH exerts in neonates during intrauterine development. Clinical markers of selenium status could thus be of great value for tracking responses of individuals to selenium supplementation as part of health improvement and harm mitigation approaches.

摘要

背景

妊娠代表着氧化应激和抗氧化剂增加的一种状态,其中硒(Se)起着关键作用,有助于维持氧化平衡。如果抗氧化防御能力耗尽,胎盘功能就会受到破坏,从而导致包括妊娠高血压(PIH)在内的妊娠并发症。关于胎儿硒状态与母亲PIH、孕周(GA)和出生体重(BW)之间的关系,人们知之甚少。

方法

在3年的时间里,我们检测了来自血压正常(非PIH)和高血压(PIH)母亲的足月新生儿的血清硒(SeS)和尿硒(SeU)状态,作为氧化应激的临床标志物。在这项回顾性观察研究中,72例患有母亲PIH的新生儿在GA和BW方面与72例血压正常母亲的新生儿进行匹配。根据母亲的PIH和相对于GA的BW(适于胎龄儿-AGA、小于胎龄儿-SGA),分为四组:非PIH-AGA(对照组)、非PIH-SGA、PIH-AGA和PIH-SGA。

结果

结果显示,研究组之间的硒水平存在显著差异(<0.001):非PIH-AGA组的SeS为44.85±7.56μg/L,非PIH-SGA组为39.62±11.42μg/L,PIH-AGA组为40.01±10.07μg/L,PIH-SGA组为25.39±8.99μg/L;非PIH-AGA组的SeU为27.98±7.99μg/L,非PIH-SGA组为22.85±9.48μg/L,PIH-AGA组为23.44±6.73μg/L,PIH-SGA组为13.05±5.86μg/L。硒缺乏在高血压母亲所生的新生儿和小于胎龄出生的新生儿中更为常见。虽然强度适中,但硒水平与BW呈正相关(SeS为0.319,SeU为0.397),与母亲收缩压呈负相关(SeS为-0.313,SeU为-0.324)。母亲的血压和出生体重对SeS和SeU的主要独立影响在统计学上具有显著性。在相互作用方面,PIH-SGA新生儿的影响更为明显。

结论

硒状态似乎反映了PIH在子宫内发育过程中对新生儿产生的负面影响。因此,作为健康改善和危害减轻方法的一部分,硒状态的临床标志物对于追踪个体对硒补充的反应可能具有重要价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb34/10101720/1ea916ffde4b/fped-11-1157689-g001.jpg

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