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Gebeliğin Term ve Geç-Term Dönemlerinde Oksidatif Stresin ve Eser Elementlerin Değerlendirilmesi

Year 2023, Issue: 21 - December, 854 - 865, 05.01.2024
https://doi.org/10.38079/igusabder.1374236

Abstract

Amaç: Gebelik, yüksek metabolik turnover (yapım-yıkım) ve doku oksijen kullanımı nedeniyle oksidatif stresin hakim olduğu fizyolojik bir durumdur. Çalışmamızda, gebeliğin term ve geç-term dönemlerinde oksidatif hasar belirteci olan malondialdehit (MDA) ve iskemi-modifiye albümin (IMA) ve bazı eser element düzeylerindeki değişiklikleri araştırmak amaçlandı.
Yöntem: Çalışmada, sefalik prezentasyonlu ve anne yaşı 18-40 arasında olan term (n=80) ve geç-term (n=64) dönemlerinde olan toplam 144 tekil gebenin olduğu bireyler değerlendirildi. Serum IMA düzeyleri albumin kobalt bağlama (CAB) testi ve MDA düzeyleri tiyobarbitürik asit reaktif maddeler (TBARS) yöntemi ile ölçüldü. Selenyum (Se), demir (Fe), bakır (Cu), mangan (Mn) ve çinko (Zn) düzeyleri indüktif eşleşmiş plazma optik emisyon spektrofotometresi (ICP-OES, Thermo iCAP-6000) ile ölçüldü.
Bulgular: Serum MDA ve IMA düzeylerinin geç-term grupta term grubundan yüksek olduğu, fakat serum Zn, Cu ve Se düzeyleri geç-term gebelerde term gebelere göre daha düşük olduğu bulunmuştur. Fe ve Mn değerlerinde anlamlı bir değişim bulunmamaktadır.
Sonuç: Çalışmamızda, gebeliğin geç-term dönemlerinde oksidatif stres belirteçleri olarak IMA ve MDA düzeylerinin yükseldiği yani oksidatif stresin arttığı belirlenmiştir. Bu bulgular, gebeliğin geç-term dönemlerinde bu oksidatif stresin kaynağı ve etkilerinin araştırılmasına ışık tutacak öncül sonuçlardır.

References

  • 1. Bahinipati J, Mohapatra PC. Ischemia modified albumin as a marker of oxidative stress in normal pregnancy. Journal of Clinical and Diagnostic Research: JCDR. 2016;10(9):BC15.
  • 2. Halliwell B. Drug antioxidant effects. Drugs. 1991;42(4):569-605.
  • 3. Al Gubory KH, Fowler PA, Garrel C. The roles of cellular reactive oxygen species, oxidative stress and antioxidants in pregnancy outcomes. Int J Biochem Cell Biol. 2010;42(10):1634–50.
  • 4. Sinclair AJ, Barnett AH, Lunec JL. Free radicals and antioxidant systems in health and diseases. British J Hosp. Med. 1990;43:334-44.
  • 5. Gülbayzar S. Yenidoğan Bebeklerde Kord Kanında (Oksidatif Stres Göstergesi Olarak) Malondialdehit [uzmanlık tezi]. İstanbul: Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi Çocuk Sağlığı ve Hastalıkları Kliniği; 2006.
  • 6. Matés JM. Effects of antioxidant enzymes in the molecular control of reactive oxygen species Toxicology. 2000;153: 83-104.
  • 7. Cikim G, Canatan H, Gursu F, et al. Levels of zinc and lipid peroxidation in acute coronary. Biol Trace Elem Res. 2003;96(1-3):61-9.
  • 8. Rahmanian M, Jahed FS, Yousefi B, Ghorbani R. Maternal serum copper and zinc levels and premature rupture of the foetal membranes. J Pak Med Assoc. 2014;64(7):770–74.
  • 9. Adamo AM, Oteiza PI. Zinc deficiency and neurodevelopment: the case of neurons. Biofactors. 2010;36(2):117–24.
  • 10. Ota E, Mori R, Middleton P, et al. Zinc supplementation for improving pregnancy and infant outcome. Cochrane Database Syst Rev. 2015(2):CD000230. doi: 10.1002/14651858.
  • 11. Gaetke LM, Chow CK. Copper toxicity, oxidative stress and antioxidant nutrients. Toxicology. 2003;189:147-63.
  • 12. Zhang SS, Noordin MM, Rahman SO, Haron J. Effects of copper overload on hepatic lipid peroxidation and defence in rats. Vet Hum Toxicol. 2000;42:261-64.
  • 13. Knight JA, Pieper RK, McClellan L. Specifity of the thiobarbituric acid reaction: Its use in studies of lipid peroxidation. Clin. Chem. 1988;34:2433-8.
  • 14. Sugio S, Kashima A, Mochizuki S, Noda M, Kobayashi K. Crystal structure of human serum albumin at 2.5A resolution. Protein Eng. 1999;12:439-46.
  • 15. Sharma R, David Gaze, Pellerin D, et al. Ischemia modified albumin and troponin predicts in haemodialysis patients. Am J Kidney Dis. 2006;47:493–502.
  • 16. Borderie D, Allanore Y, Meune C, Devaux JY, Ekindjian OG, Kahan A. High ischemiamodified albumin concentration reflects oxidative stress but not myocardial involvement in systemic sclerosis. Clinical Chemistry. 2004;50(11):2190-2193.
  • 17. Sbarouni E, Georgiadou P, Voudris V. Ischemia modified albumin changes - review and clinical implications. Clin Chem Lab Med. 2011;49:177-84.
  • 18. Zuwała-Jagiełło J, Warwas M, Pazgan-Simon M. Ischemia-modified albumin (IMA) is increased in patients with chronic hepatitis C infection and related to markers of oxidative stress and inflammation. Acta Biochim Pol. 2012;59:661-7.
  • 19. Bhagavan NV, Lai EM, Rios PA, et al. Evaluation of human serum albumin cobalt binding assay for the assessment of myocardial ischemia and myocardial infarction. Clin Chem. 2003;49(4):581-5.
  • 20. Ohkawa H, Ohishi N, Yagi K. Assay for lipid peroxides in animal tissues by thiobarbituric acid reaction. Anal Biochem. 1979;95:351-8.
  • 21. Yiğenoğlu A. Eser Element Tayini ile Ban otu Bitkisinin Yetiştiği Bölgenin Tahmini [yüksek lisans]. Ankara: Gazi Üniversitesi, Fen Bilimleri Enstitüsü; 2007.
  • 22. Toescu V, Nuttall SL, Martin U, Kendall MJ, Dunne F. Oxidative stress and normal pregnancy. Clin Endocrinol (Oxf). 2002;57(5):609-13.
  • 23. Arikan S, Konukoglu D, Arikan C, Akcay T, Davas I. Lipid peroxidation and antioxidant status in maternal and cord blood. Gynecol Obstet Invest. 2001;51:145–149.
  • 24. Wang Y, Walsh SW, Guo J, Zhang J. The imbalance between thromboxane and prostacyclin in preeclampsia is associated with an imbalance between lipid peroxides and vitamin E in maternal blood. Am J Obstet Gynecol. 1991;165:1695–1700.
  • 25. Pentieva K, Ivanova L, Petrova S, Ovcharova D, Vatralova K, Angelova K. Promeni v nivoto na lipidnata peroksidatsiia pri zdravi bremenni zheni [Changes in the level of lipid peroxidation in healthy pregnant women]. Akush Ginekol (Sofiia). 1995;34(3):19-21.
  • 26. Qanungo S, Mukherjea M. Ontogenic profile of some antioxidants and lipid peroxidation in human placental and fetal tissues. Mol Cell Biochem. 2000;215(1-2):11-9.
  • 27. Basbug M, Demir I, Serin IS, et al. Maternal erythrocyte malondialdehyde level in preeclampsia prediction: a longitudinal study. J Perinat Med. 2003;31(6):469-74.
  • 28. Sinha MK, Roy D, Gaze DC, et al. Role of ‘Ischemia-modified albumin’, a new biochemical marker of myocardial ischaemia, in the early diagnosis of acute coronary syndromes. Emerg Med J. 2004;21:29-34.
  • 29. Guven S. The novel ischemia marker ‘ischemia-modified albumin’ is increased in normal pregnancies. Acta Obstetricia et Gynecologica. 2009;88(4):479–82.
  • 30. Papageorghiou AT, Prefumo F. Defective endovascular trophoblast invasion in the first trimester is associated with increased maternal serum ischemia-modified albumin. Hum Reprod. 2008;23(4):803-6.
  • 31. Caglar GS, Erdogdu P. The impact of route of anesthesia on maternal and fetal ischemia modified albumin levels at cesarean section: a prospective randomized study. J Perinat Med. 2013;41(5):573-9.
  • 32. International Zinc Nutrition Consultative Group (IZiNCG), Brown KH, Rivera JA, Bhutta Z, et al. International Zinc Nutrition Consultative Group (IZiNCG) technical document #1. Assessment of the risk of zinc deficiency in populations and options for its control. Food Nutr. Bull. 2004;25(1Suppl. 2):99–203.
  • 33. Izquierdo Alvarez S, Castañón SG, Calvo Ruata ML, et al. Updating of normal levels of copper, zinc and selenium in serum of pregnant women. J. Trace Elem. Med. Biol. Organ Soc. Miner. Trace Elem. 2007:49-52.
  • 34. Khoushabi F, Shadan MR, Miri A, Sharifi-Rad J. Determination of maternal serum zinc, iron, calcium and magnesium durıng pregnancy in pregnant women and umbilical cord blood and their association with outcome of pregnancy. Mater Sociomed. 2016;28(2):104-7.
  • 35. Liu J, Yang H, Shi H, et al. Blood copper, zinc, calcium, and magnesium levels during different duration of pregnancy in chinese. Biol Trace Elem Res. 2010;135:31–7.
  • 36. Tamura T, Goldenberg RL, Johnston KE, DuBard M. Maternal plasma zinc concentrations and pregnancy outcome. Am J Clin Nutr. 2000;71:109–13.
  • 37. Tuttle S. Trace Element Requirements During Pregnancy. In: Campbell DM, Gillmer MDG, editors. Nutrition In Pregnancy. London: Royal College of Gynaecologists; 1983.
  • 38. Tabrizi FM, Pakdel FG. Serum level of some minerals during three trimesters of pregnancy in Iranian women and their newborns: a longitudinal study. Indian J Clin Biochem. 2014;29(2):174-34.
  • 39. Kurlak LO, Scaife PJ, Briggs LV, Broughton Pipkin F, Gardner DS, Mistry HD. Alterations in antioxidant micronutrient concentrations in placental tissue, maternal blood and urine and the fetal circulation in pre-eclampsia. Int J Mol Sci. 2023;24(4):3579.

Evaluation of Oxidative Stress and Trace Elements in Term and Late-Term Pregnancies

Year 2023, Issue: 21 - December, 854 - 865, 05.01.2024
https://doi.org/10.38079/igusabder.1374236

Abstract

Aim: Pregnancy is a physiological condition characterised by oxidative stress due to high metabolic turnover (synthesis-breakdown) and tissue oxygen use. Our study aimed to investigate the changes in the levels of malondialdehyde (MDA), ischemia-modified albumin (IMA), and some trace elements, which are markers of oxidative damage, during the term and late-term periods of pregnancy.
Method: In our study, 144 singleton pregnant women with cephalic presentation and maternal age between 18-40 years in the term (N=80) and late-term (N=64) periods were evaluated. Serum IMA levels were measured by the albumin cobalt binding (CAB) test and MDA levels were measured by the thiobarbituric acid reactive substances (TBARS) method. Selenium (Se), iron (Fe), cobalt (Co), manganese (Mn), and zinc (Zn) levels were measured using an inductively coupled plasma optical emission spectrophotometer (ICP-OES, Thermo iCAP-6000).
Results: Serum MDA levels and IMA levels were found to be higher in the late-term group than in the term group, but serum Zn, Cu, and Se levels were lower in late-term pregnant women than in term pregnant women. There was no significant change in Fe and Mn values.
Conclusion: In our study, it was determined that IMA and MDA levels, as oxidative stress markers, increased in the late-term periods of pregnancy, i.e., oxidative stress increased. These findings are preliminary results that will shed light on investigating the source and effects of this oxidative stress in the late-term periods of pregnancy.

References

  • 1. Bahinipati J, Mohapatra PC. Ischemia modified albumin as a marker of oxidative stress in normal pregnancy. Journal of Clinical and Diagnostic Research: JCDR. 2016;10(9):BC15.
  • 2. Halliwell B. Drug antioxidant effects. Drugs. 1991;42(4):569-605.
  • 3. Al Gubory KH, Fowler PA, Garrel C. The roles of cellular reactive oxygen species, oxidative stress and antioxidants in pregnancy outcomes. Int J Biochem Cell Biol. 2010;42(10):1634–50.
  • 4. Sinclair AJ, Barnett AH, Lunec JL. Free radicals and antioxidant systems in health and diseases. British J Hosp. Med. 1990;43:334-44.
  • 5. Gülbayzar S. Yenidoğan Bebeklerde Kord Kanında (Oksidatif Stres Göstergesi Olarak) Malondialdehit [uzmanlık tezi]. İstanbul: Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi Çocuk Sağlığı ve Hastalıkları Kliniği; 2006.
  • 6. Matés JM. Effects of antioxidant enzymes in the molecular control of reactive oxygen species Toxicology. 2000;153: 83-104.
  • 7. Cikim G, Canatan H, Gursu F, et al. Levels of zinc and lipid peroxidation in acute coronary. Biol Trace Elem Res. 2003;96(1-3):61-9.
  • 8. Rahmanian M, Jahed FS, Yousefi B, Ghorbani R. Maternal serum copper and zinc levels and premature rupture of the foetal membranes. J Pak Med Assoc. 2014;64(7):770–74.
  • 9. Adamo AM, Oteiza PI. Zinc deficiency and neurodevelopment: the case of neurons. Biofactors. 2010;36(2):117–24.
  • 10. Ota E, Mori R, Middleton P, et al. Zinc supplementation for improving pregnancy and infant outcome. Cochrane Database Syst Rev. 2015(2):CD000230. doi: 10.1002/14651858.
  • 11. Gaetke LM, Chow CK. Copper toxicity, oxidative stress and antioxidant nutrients. Toxicology. 2003;189:147-63.
  • 12. Zhang SS, Noordin MM, Rahman SO, Haron J. Effects of copper overload on hepatic lipid peroxidation and defence in rats. Vet Hum Toxicol. 2000;42:261-64.
  • 13. Knight JA, Pieper RK, McClellan L. Specifity of the thiobarbituric acid reaction: Its use in studies of lipid peroxidation. Clin. Chem. 1988;34:2433-8.
  • 14. Sugio S, Kashima A, Mochizuki S, Noda M, Kobayashi K. Crystal structure of human serum albumin at 2.5A resolution. Protein Eng. 1999;12:439-46.
  • 15. Sharma R, David Gaze, Pellerin D, et al. Ischemia modified albumin and troponin predicts in haemodialysis patients. Am J Kidney Dis. 2006;47:493–502.
  • 16. Borderie D, Allanore Y, Meune C, Devaux JY, Ekindjian OG, Kahan A. High ischemiamodified albumin concentration reflects oxidative stress but not myocardial involvement in systemic sclerosis. Clinical Chemistry. 2004;50(11):2190-2193.
  • 17. Sbarouni E, Georgiadou P, Voudris V. Ischemia modified albumin changes - review and clinical implications. Clin Chem Lab Med. 2011;49:177-84.
  • 18. Zuwała-Jagiełło J, Warwas M, Pazgan-Simon M. Ischemia-modified albumin (IMA) is increased in patients with chronic hepatitis C infection and related to markers of oxidative stress and inflammation. Acta Biochim Pol. 2012;59:661-7.
  • 19. Bhagavan NV, Lai EM, Rios PA, et al. Evaluation of human serum albumin cobalt binding assay for the assessment of myocardial ischemia and myocardial infarction. Clin Chem. 2003;49(4):581-5.
  • 20. Ohkawa H, Ohishi N, Yagi K. Assay for lipid peroxides in animal tissues by thiobarbituric acid reaction. Anal Biochem. 1979;95:351-8.
  • 21. Yiğenoğlu A. Eser Element Tayini ile Ban otu Bitkisinin Yetiştiği Bölgenin Tahmini [yüksek lisans]. Ankara: Gazi Üniversitesi, Fen Bilimleri Enstitüsü; 2007.
  • 22. Toescu V, Nuttall SL, Martin U, Kendall MJ, Dunne F. Oxidative stress and normal pregnancy. Clin Endocrinol (Oxf). 2002;57(5):609-13.
  • 23. Arikan S, Konukoglu D, Arikan C, Akcay T, Davas I. Lipid peroxidation and antioxidant status in maternal and cord blood. Gynecol Obstet Invest. 2001;51:145–149.
  • 24. Wang Y, Walsh SW, Guo J, Zhang J. The imbalance between thromboxane and prostacyclin in preeclampsia is associated with an imbalance between lipid peroxides and vitamin E in maternal blood. Am J Obstet Gynecol. 1991;165:1695–1700.
  • 25. Pentieva K, Ivanova L, Petrova S, Ovcharova D, Vatralova K, Angelova K. Promeni v nivoto na lipidnata peroksidatsiia pri zdravi bremenni zheni [Changes in the level of lipid peroxidation in healthy pregnant women]. Akush Ginekol (Sofiia). 1995;34(3):19-21.
  • 26. Qanungo S, Mukherjea M. Ontogenic profile of some antioxidants and lipid peroxidation in human placental and fetal tissues. Mol Cell Biochem. 2000;215(1-2):11-9.
  • 27. Basbug M, Demir I, Serin IS, et al. Maternal erythrocyte malondialdehyde level in preeclampsia prediction: a longitudinal study. J Perinat Med. 2003;31(6):469-74.
  • 28. Sinha MK, Roy D, Gaze DC, et al. Role of ‘Ischemia-modified albumin’, a new biochemical marker of myocardial ischaemia, in the early diagnosis of acute coronary syndromes. Emerg Med J. 2004;21:29-34.
  • 29. Guven S. The novel ischemia marker ‘ischemia-modified albumin’ is increased in normal pregnancies. Acta Obstetricia et Gynecologica. 2009;88(4):479–82.
  • 30. Papageorghiou AT, Prefumo F. Defective endovascular trophoblast invasion in the first trimester is associated with increased maternal serum ischemia-modified albumin. Hum Reprod. 2008;23(4):803-6.
  • 31. Caglar GS, Erdogdu P. The impact of route of anesthesia on maternal and fetal ischemia modified albumin levels at cesarean section: a prospective randomized study. J Perinat Med. 2013;41(5):573-9.
  • 32. International Zinc Nutrition Consultative Group (IZiNCG), Brown KH, Rivera JA, Bhutta Z, et al. International Zinc Nutrition Consultative Group (IZiNCG) technical document #1. Assessment of the risk of zinc deficiency in populations and options for its control. Food Nutr. Bull. 2004;25(1Suppl. 2):99–203.
  • 33. Izquierdo Alvarez S, Castañón SG, Calvo Ruata ML, et al. Updating of normal levels of copper, zinc and selenium in serum of pregnant women. J. Trace Elem. Med. Biol. Organ Soc. Miner. Trace Elem. 2007:49-52.
  • 34. Khoushabi F, Shadan MR, Miri A, Sharifi-Rad J. Determination of maternal serum zinc, iron, calcium and magnesium durıng pregnancy in pregnant women and umbilical cord blood and their association with outcome of pregnancy. Mater Sociomed. 2016;28(2):104-7.
  • 35. Liu J, Yang H, Shi H, et al. Blood copper, zinc, calcium, and magnesium levels during different duration of pregnancy in chinese. Biol Trace Elem Res. 2010;135:31–7.
  • 36. Tamura T, Goldenberg RL, Johnston KE, DuBard M. Maternal plasma zinc concentrations and pregnancy outcome. Am J Clin Nutr. 2000;71:109–13.
  • 37. Tuttle S. Trace Element Requirements During Pregnancy. In: Campbell DM, Gillmer MDG, editors. Nutrition In Pregnancy. London: Royal College of Gynaecologists; 1983.
  • 38. Tabrizi FM, Pakdel FG. Serum level of some minerals during three trimesters of pregnancy in Iranian women and their newborns: a longitudinal study. Indian J Clin Biochem. 2014;29(2):174-34.
  • 39. Kurlak LO, Scaife PJ, Briggs LV, Broughton Pipkin F, Gardner DS, Mistry HD. Alterations in antioxidant micronutrient concentrations in placental tissue, maternal blood and urine and the fetal circulation in pre-eclampsia. Int J Mol Sci. 2023;24(4):3579.
There are 39 citations in total.

Details

Primary Language Turkish
Subjects Medical Biochemistry and Metabolomics (Other)
Journal Section Articles
Authors

Esra Güler Aksoy 0009-0003-4762-6238

Nurten Bahtiyar 0000-0003-2420-8415

Gamze Karakullukçu Savaş 0000-0002-2941-8473

Leyla Sevinç Avşar This is me 0000-0003-4122-5452

Betül Nur Çoban Kayan 0000-0003-3013-8708

Nermin Akdemir 0000-0002-9129-2103

Birsen Aydemir 0000-0003-1406-864X

Fatma Behice Cinemre 0000-0002-1972-1575

Early Pub Date January 8, 2024
Publication Date January 5, 2024
Submission Date October 11, 2023
Acceptance Date December 11, 2023
Published in Issue Year 2023 Issue: 21 - December

Cite

APA Aksoy, E. G., Bahtiyar, N., Karakullukçu Savaş, G., Sevinç Avşar, L., et al. (2024). Gebeliğin Term ve Geç-Term Dönemlerinde Oksidatif Stresin ve Eser Elementlerin Değerlendirilmesi. İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi(21), 854-865. https://doi.org/10.38079/igusabder.1374236
AMA Aksoy EG, Bahtiyar N, Karakullukçu Savaş G, Sevinç Avşar L, Çoban Kayan BN, Akdemir N, Aydemir B, Cinemre FB. Gebeliğin Term ve Geç-Term Dönemlerinde Oksidatif Stresin ve Eser Elementlerin Değerlendirilmesi. IGUSABDER. January 2024;(21):854-865. doi:10.38079/igusabder.1374236
Chicago Aksoy, Esra Güler, Nurten Bahtiyar, Gamze Karakullukçu Savaş, Leyla Sevinç Avşar, Betül Nur Çoban Kayan, Nermin Akdemir, Birsen Aydemir, and Fatma Behice Cinemre. “Gebeliğin Term Ve Geç-Term Dönemlerinde Oksidatif Stresin Ve Eser Elementlerin Değerlendirilmesi”. İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi, no. 21 (January 2024): 854-65. https://doi.org/10.38079/igusabder.1374236.
EndNote Aksoy EG, Bahtiyar N, Karakullukçu Savaş G, Sevinç Avşar L, Çoban Kayan BN, Akdemir N, Aydemir B, Cinemre FB (January 1, 2024) Gebeliğin Term ve Geç-Term Dönemlerinde Oksidatif Stresin ve Eser Elementlerin Değerlendirilmesi. İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi 21 854–865.
IEEE E. G. Aksoy, “Gebeliğin Term ve Geç-Term Dönemlerinde Oksidatif Stresin ve Eser Elementlerin Değerlendirilmesi”, IGUSABDER, no. 21, pp. 854–865, January 2024, doi: 10.38079/igusabder.1374236.
ISNAD Aksoy, Esra Güler et al. “Gebeliğin Term Ve Geç-Term Dönemlerinde Oksidatif Stresin Ve Eser Elementlerin Değerlendirilmesi”. İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi 21 (January 2024), 854-865. https://doi.org/10.38079/igusabder.1374236.
JAMA Aksoy EG, Bahtiyar N, Karakullukçu Savaş G, Sevinç Avşar L, Çoban Kayan BN, Akdemir N, Aydemir B, Cinemre FB. Gebeliğin Term ve Geç-Term Dönemlerinde Oksidatif Stresin ve Eser Elementlerin Değerlendirilmesi. IGUSABDER. 2024;:854–865.
MLA Aksoy, Esra Güler et al. “Gebeliğin Term Ve Geç-Term Dönemlerinde Oksidatif Stresin Ve Eser Elementlerin Değerlendirilmesi”. İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi, no. 21, 2024, pp. 854-65, doi:10.38079/igusabder.1374236.
Vancouver Aksoy EG, Bahtiyar N, Karakullukçu Savaş G, Sevinç Avşar L, Çoban Kayan BN, Akdemir N, Aydemir B, Cinemre FB. Gebeliğin Term ve Geç-Term Dönemlerinde Oksidatif Stresin ve Eser Elementlerin Değerlendirilmesi. IGUSABDER. 2024(21):854-65.

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