Department of Obstetrics and Gynecology, Health Sciences University Etlik Zubeyde Hanim Maternity, Teaching and Research Hospital, Ankara, Turkey.
Eur Rev Med Pharmacol Sci. 2024 Feb;28(4):1471-1479. doi: 10.26355/eurrev_202402_35477.
Thiols are organic compounds containing sulfhydryl groups that exert antioxidant effects via dynamic thiol-disulfide homeostasis. The shift towards disulfide indicates the presence of an oxidative environment. Different modes of delivery can affect thiol-disulfide homeostasis. Accordingly, we planned this research to evaluate the effects of the mode of delivery on thiol-disulfide homeostasis in both maternal serum and fetal cord blood samples.
We conducted a prospective case-control study involving two groups: vaginal delivery (n=50) and elective cesarean section (CS) (n=45). The vaginal delivery group exclusively comprised uncomplicated term deliveries, while the CS group included pregnant individuals with scheduled cesarean deliveries due to the absence of spontaneous labor onset. Maternal serum and fetal cord blood samples were collected, and thiol-disulfide exchanges were analyzed using an automated method capable of measuring both aspects of the thiol-disulfide balance.
The levels of native thiol (-SH) and total thiol in both maternal serum and fetal cord blood samples were significantly higher in the vaginal delivery group than those in the CS group. An important discovery of our study was that fetal cord disulfide (-SS) level, which may reflect oxidative stress, was higher in newborns born via vaginal delivery when examined alone. However, in both maternal and fetal cord blood, the combined ratios, SS/SH ratio (%), SS/Total thiol ratio (%), and SH/Total thiol ratio (%) were observed to be similar between the groups in both maternal and fetal cord blood. It was observed that as the mother's weight gained during pregnancy increased, SS/SH and SS/total thiol increased (positive correlation), while SH/total thiol decreased (negative correlation).
Our results showed that the dynamic thiol-disulfide homeostasis was greatly influenced by the way of delivery and supported the idea that vaginally-delivered infants may have more oxidative stress.
巯基是含有巯基基团的有机化合物，通过动态的巯基-二硫键平衡发挥抗氧化作用。二硫键的形成表明存在氧化环境。不同的给药方式会影响巯基-二硫键平衡。因此，我们计划进行这项研究，以评估给药方式对母血清和胎儿脐血样本中巯基-二硫键平衡的影响。
我们进行了一项前瞻性病例对照研究，纳入两组：阴道分娩（n=50）和择期剖宫产（CS）（n=45）。阴道分娩组仅包括无并发症的足月分娩，而 CS 组包括因无自发临产而计划行剖宫产的孕妇。采集母血清和胎儿脐血样本，并使用能够测量巯基-二硫键平衡两方面的自动方法分析巯基-二硫键交换。
阴道分娩组母血清和胎儿脐血样本中的天然巯基（-SH）和总巯基水平均显著高于 CS 组。我们研究的一个重要发现是，单独检查时，经阴道分娩的新生儿的胎儿脐血中二硫键（-SS）水平更高，这可能反映了氧化应激。然而，在母血清和胎儿脐血中，SS/SH 比值（%）、SS/总巯基比值（%）和 SH/总巯基比值（%）在母血和胎血中均观察到两组间相似。观察到随着孕妇怀孕期间体重增加，SS/SH 和 SS/总巯基增加（正相关），而 SH/总巯基减少（负相关）。
我们的结果表明，动态巯基-二硫键平衡受分娩方式的影响很大，并支持阴道分娩的婴儿可能存在更多氧化应激的观点。
