Doğum eyleminde maternal ve fetal kanda melatonin ve beta-endorfin düzeylerinin değerlendirilmesi

Abstract

Amaç: Melatonin vücutta birçok biyolojik düzenlemede görev alan ve oksidatif stresle ilişkili bir nörotransmitterdir. Β-endorfin ise morfin benzeri özelliği olan ve benzer şekilde ağrı ve oksidatif stresle ilişkili durumlarda hipofiz bezinden salgılanan doğal bir narkotiktir. Biz bu çalışmada, elektif sezaryen ile doğum yapan veya normal doğum eylemi başladıktan sonra sezaryen ile doğum yapan gebelerde, maternal kanda ve kord kanında, melatonin ve β-endorfin seviyelerini araştırmayı amaçladık. Gereç ve Yöntem: Çalışmamıza, sezaryen ile doğum yapan 80 gebe dahil edilmiştir. Normal doğum eylemi başladıktan sonra sezaryen ile doğumun gerçekleştiği olgular Grup 1 (n=30), elektif sezaryen ile doğumun gerçekleştiği olgular Grup 2 (n=50) olarak adlandırıldı. İki grubun demografik ve klinik verileri kaydedildi. Maternal ve kord kanından alınan venöz kandan elde edilen serum örneklerinde melatonin ve β-endorfin düzeyleri analiz edildi. Elde edilen datalar iki grup arasında karşılaştırıldı. Bulgular: Umbilikal kord melatonin ve maternal β-endorfin düzeyleri karşılaştırıldığında ise her iki hormon düzeyinin de grup 1’de grup 2’ye kıyasla anlamlı olarak daha yüksek olduğu tespit edildi (sırasıyla; p=0.04, p=0.001). Maternal melatonin ve maternal β-endorfin düzeyleri açısından iki grup arasında istatiksel anlamlı fark saptanmadı (sırasıyla; p=0.18, p=0.16). Sonuç: Melatonin ve β-endorfin düzeylerinin oksidatif stres ile ilişkili olduğu bilinmektedir ve bu hormonların düzeyinin normal doğum başladıktan sonra yapılan sezaryen doğumlardaki kord kanında anlamlı olarak daha yüksek olduğu saptanmıştır. Bu bulgular, melatonin ve β-endorfinin spontan doğumun başlangıcında veya spontan doğum sürecinde rol alabilecek olası fizyolojik yolaklarda görev alabileceğini düşündürmektedir. Melatonin ve β-endorfinin yenidoğandaki olası etkilerini de araştırmak için, elektif sezaryen doğumlardan ve spontan doğum eylemi başladıktan sonra gerçekleştirilen sezaryen doğumlardan sonraki yenidoğan izlemini de dahil eden çalışmalar planlanabilir.

Keywords

• Oksidatif stres
• Sezaryenle doğum
• Spontan doğum eylemi
• Melatonin
• Endorfin

Assessment of maternal and cord blood serum melatonin and beta-endorphin levels in labor

Abstract

Aim: Melatonin is a neurotransmitter released under oxidative stress condition and involved in a number of biological regulatory pathways. β-endorphin is a natural narcotic with morphine-like properties and similarly secreted from the pituitary gland in cases associated with pain and oxidative stress. In this study, we aimed to investigate the melatonin and β-endorphin levels in maternal and cord blood serum of pregnant women who delivered by cesarean after normal labor started compared to pregnant women delivered by elective cesarean. Materials and Method: 80 pregnant women who gave birth by cesarean delivery were included. The cesarean deliveries performed after normal labor started consisted of Group(n=30), and the elective cesarean deliveries were included in Group 2(n=50). Sociodemographic characteristics,and clinical features of the groups were recorded. Serum samples from maternal and cord venous blood were analyzed for melatonin and β-endorphin levels were analyzed from. The data were compared between the two groups. Results: The umbilical cord melatonin levels and maternal β-endorphin levels both were found to be significantly increased in group 1,compared to group 2 (p=0.04; p=0.001,respectively). There was no statistically significant difference between the two groups in terms of maternal melatonin and maternal β-endorphin levels (p=0.18; p=0.16,respectively). Conclusion: The serum level of melatonin and β-endorphin which have known to be related with oxidative stress were found to be significantly increased in the cord blood, in cesarean deliveries performed after the onset of normal labor. This finding should be considered to indicate the possible physiological pathways through which melatonin and β-endorphin may take role at onset of spontaneous labor or during the spontaneous delivery process. Studies may be planned through neonatal follow-up to investigate the possible effects of melatonin and β-endorphin regarding to elective cesarean deliveries and cesarean deliveries after the onset of spontaneous labor.

Keywords

• Cesarean delivery
• Endorphin
• Melatonin
• Oxidative stress
• Spontaneous labor

References

1. 1. Brzezinski A. Melatonin in humans. N Engl J Med. 1997;336(3):186-95.
2. 1. Brzezinski A. Melatonin in humans. N Engl J Med. 1997;336(3):186-95.
3. 2. Carrillo-Vico A, Calvo JR, Abreu P, Lardone PJ, García-Mauriño S, Reiter RJ, et al. Evidence of melatonin synthesis by human lymphocytes and its physiological significance: possible role as intracrine, autocrine, and/or paracrine substance. FASEB J. 2004;18(3):537-9.
4. 2. Carrillo-Vico A, Calvo JR, Abreu P, Lardone PJ, García-Mauriño S, Reiter RJ, et al. Evidence of melatonin synthesis by human lymphocytes and its physiological significance: possible role as intracrine, autocrine, and/or paracrine substance. FASEB J. 2004;18(3):537-9.
5. 3. Claustrat B, Brun J, Chazot G. The basic physiology and pathophysiology of melatonin. Sleep Med Rev. 2005;9(1):11-24.
6. 3. Claustrat B, Brun J, Chazot G. The basic physiology and pathophysiology of melatonin. Sleep Med Rev. 2005;9(1):11-24.
7. 4. Tan DX, Manchester LC, Sanchez-Barcelo E, Mediavilla MD, Reiter RJ. Significance of high levels of endogenous melatonin in Mammalian cerebrospinal fluid and in the central nervous system. Curr Neuropharmacol. 2010;8(3):162-7.
8. 4. Tan DX, Manchester LC, Sanchez-Barcelo E, Mediavilla MD, Reiter RJ. Significance of high levels of endogenous melatonin in Mammalian cerebrospinal fluid and in the central nervous system. Curr Neuropharmacol. 2010;8(3):162-7.

9. 5. Reiter RJ, Tan DX, Korkmaz A, Rosales-Corral SA. Melatonin and stable circadian rhythms optimize maternal, placental and fetal physiology. Hum Reprod Update. 2014;20(2):293-307.
10. 5. Reiter RJ, Tan DX, Korkmaz A, Rosales-Corral SA. Melatonin and stable circadian rhythms optimize maternal, placental and fetal physiology. Hum Reprod Update. 2014;20(2):293-307.
11. 6. Tamura H, Nakamura Y, Terron MP, Flores LJ, Manchester LC, Tan DX, et al. Melatonin and pregnancy in the human. Reprod Toxicol. 2008;25(3):291-303.
12. 6. Tamura H, Nakamura Y, Terron MP, Flores LJ, Manchester LC, Tan DX, et al. Melatonin and pregnancy in the human. Reprod Toxicol. 2008;25(3):291-303.
13. 7. Sagrillo-Fagundes L, Soliman A, Vaillancourt C. Maternal and placental melatonin: actions and implication for successful pregnancies. Minerva Gynecol. 2014;66(3):251-66.
14. 7. Sagrillo-Fagundes L, Soliman A, Vaillancourt C. Maternal and placental melatonin: actions and implication for successful pregnancies. Minerva Gynecol. 2014;66(3):251-66.
15. 8. Lanoix D, Beghdadi H, Lafond J, Vaillancourt C. Human placental trophoblasts synthesize melatonin and express its receptors. J Pineal Res. 2008;45(1):50-60.
16. 8. Lanoix D, Beghdadi H, Lafond J, Vaillancourt C. Human placental trophoblasts synthesize melatonin and express its receptors. J Pineal Res. 2008;45(1):50-60.
17. 9. Okatani Y, Okamoto K, Hayashi K, Wakatsuki A, Tamura S, Sagara Y. Maternal-fetal transfer of melatonin in pregnant women near term. J Pineal Res. 1998;25(3):129-34.
18. 9. Okatani Y, Okamoto K, Hayashi K, Wakatsuki A, Tamura S, Sagara Y. Maternal-fetal transfer of melatonin in pregnant women near term. J Pineal Res. 1998;25(3):129-34.
19. 10. Ducsay CA, Yellon SM. Photoperiod regulation of uterine activity and melatonin rhythms in the pregnant rhesus macaque. Biol Reprod. 1991;44(6):967-74.
20. 10. Ducsay CA, Yellon SM. Photoperiod regulation of uterine activity and melatonin rhythms in the pregnant rhesus macaque. Biol Reprod. 1991;44(6):967-74.
21. 11. Mårtensson LG, Andersson RG, Berg G. Melatonin together with noradrenaline augments contractions of human myometrium. Eur J Pharmacol. 1996;316(2-3):273-5.
22. 11. Mårtensson LG, Andersson RG, Berg G. Melatonin together with noradrenaline augments contractions of human myometrium. Eur J Pharmacol. 1996;316(2-3):273-5.
23. 12. Shang Y, Xu SP, Wu Y, Jiang YX, Wu ZY, Yuan SY, et al. Melatonin reduces acute lung injury in endotoxemic rats. Chin Med J (Engl). 2009;122(12):1388-93.
24. 12. Shang Y, Xu SP, Wu Y, Jiang YX, Wu ZY, Yuan SY, et al. Melatonin reduces acute lung injury in endotoxemic rats. Chin Med J (Engl). 2009;122(12):1388-93.
25. 13. Lekic T, Manaenko A, Rolland W, Virbel K, Hartman R, Tang J, et al. Neuroprotection by melatonin after germinal matrix hemorrhage in neonatal rats. Acta Neurochir Suppl. 2011;111:201-6.
26. 13. Lekic T, Manaenko A, Rolland W, Virbel K, Hartman R, Tang J, et al. Neuroprotection by melatonin after germinal matrix hemorrhage in neonatal rats. Acta Neurochir Suppl. 2011;111:201-6.
27. 14. Gitto E, Karbownik M, Reiter RJ, Tan DX, Cuzzocrea S, Chiurazzi P, et al. Effects of melatonin treatment in septic newborns. Pediatr Res. 2001;50(6):756-60.
28. 14. Gitto E, Karbownik M, Reiter RJ, Tan DX, Cuzzocrea S, Chiurazzi P, et al. Effects of melatonin treatment in septic newborns. Pediatr Res. 2001;50(6):756-60.
29. 15. Raffin-Sanson ML, Ferré F, Coste J, Oliver C, Cabrol D, Bertagna X. Pro-opiomelanocortin in human pregnancy: evolution of maternal plasma levels, concentrations in cord blood, amniotic fluid and at the feto-maternal interface. Eur J Endocrinol. 2000;142(1):53-9.
30. 15. Raffin-Sanson ML, Ferré F, Coste J, Oliver C, Cabrol D, Bertagna X. Pro-opiomelanocortin in human pregnancy: evolution of maternal plasma levels, concentrations in cord blood, amniotic fluid and at the feto-maternal interface. Eur J Endocrinol. 2000;142(1):53-9.
31. 16. Mitchell MD, Bibby JG, Sayers L, Anderson AB, Turnbull AC. Melatonin in the maternal and umbilical circulations during human parturition. Br J Obstet Gynaecol. 1979;86(1):29-31.
32. 16. Mitchell MD, Bibby JG, Sayers L, Anderson AB, Turnbull AC. Melatonin in the maternal and umbilical circulations during human parturition. Br J Obstet Gynaecol. 1979;86(1):29-31.
33. 17. Cotzias CS, Paterson-Brown S, Fisk NM. Obstetricians say yes to maternal request for elective caesarean section: a survey of current opinion. Eur J Obstet Gynecol Reprod Biol. 2001;97(1):15-6.
34. 17. Cotzias CS, Paterson-Brown S, Fisk NM. Obstetricians say yes to maternal request for elective caesarean section: a survey of current opinion. Eur J Obstet Gynecol Reprod Biol. 2001;97(1):15-6.
35. 18. Romano AM, Lothian JA. Promoting, protecting, and supporting normal birth: a look at the evidence. J Obstet Gynecol Neonatal Nurs. 2008;37(1):94-104; quiz -5.
36. 18. Romano AM, Lothian JA. Promoting, protecting, and supporting normal birth: a look at the evidence. J Obstet Gynecol Neonatal Nurs. 2008;37(1):94-104; quiz -5.
37. 19. Sharkey JT, Puttaramu R, Word RA, Olcese J. Melatonin synergizes with oxytocin to enhance contractility of human myometrial smooth muscle cells. J Clin Endocrinol Metab. 2009;94(2):421-7.
38. 19. Sharkey JT, Puttaramu R, Word RA, Olcese J. Melatonin synergizes with oxytocin to enhance contractility of human myometrial smooth muscle cells. J Clin Endocrinol Metab. 2009;94(2):421-7.
39. 20. Bagci S, Mueller A, Reinsberg J, Heep A, Bartmann P, Franz AR. Utility of salivary melatonin measurements in the assessment of the pineal physiology in newborn infants. Clin Biochem. 2010;43(10-11):868-72.
40. 20. Bagci S, Mueller A, Reinsberg J, Heep A, Bartmann P, Franz AR. Utility of salivary melatonin measurements in the assessment of the pineal physiology in newborn infants. Clin Biochem. 2010;43(10-11):868-72.
41. 21. Katzer D, Mueller A, Welzing L, Reutter H, Reinsberg J, Bartmann P, et al. Antioxidative status and oxidative stress in the fetal circulation at birth: the effects of time of delivery and presence of labor. Early Hum Dev. 2015;91(2):119-24.
42. 21. Katzer D, Mueller A, Welzing L, Reutter H, Reinsberg J, Bartmann P, et al. Antioxidative status and oxidative stress in the fetal circulation at birth: the effects of time of delivery and presence of labor. Early Hum Dev. 2015;91(2):119-24.
43. 22. Namlı Kalem M, Kalem Z, Yuce T, Bakırarar B, Söylemez F. Comparison of Melatonin Levels in the Colostrum between Vaginal Delivery and Cesarean Delivery. Am J Perinatol. 2018;35(5):481-5.
44. 22. Namlı Kalem M, Kalem Z, Yuce T, Bakırarar B, Söylemez F. Comparison of Melatonin Levels in the Colostrum between Vaginal Delivery and Cesarean Delivery. Am J Perinatol. 2018;35(5):481-5.
45. 23. Aurich J, Dobrinski I, Hoppen H-O, Grunert E. β-Endorphin and met-enkephalin in plasma of cattle during pregnancy, parturition and the neonatal period. Reproduction. 1990;89(2):605-12.
46. 23. Aurich J, Dobrinski I, Hoppen H-O, Grunert E. β-Endorphin and met-enkephalin in plasma of cattle during pregnancy, parturition and the neonatal period. Reproduction. 1990;89(2):605-12.
47. 24. Bacigalupo G, Langner K, Schmidt S, Saling E. Plasma immunoreactive beta-endorphin, ACTH and Cortisol concentrations in mothers and their neonates immediately after delivery—their relationship to the duration of labor. J Perinat Med. 1987; 15(1):45-52.
48. 24. Bacigalupo G, Langner K, Schmidt S, Saling E. Plasma immunoreactive beta-endorphin, ACTH and Cortisol concentrations in mothers and their neonates immediately after delivery—their relationship to the duration of labor. J Perinat Med. 1987; 15(1):45-52.
49. 25. Pilozzi A, Carro C, Huang X. Roles of β-Endorphin in Stress, Behavior, Neuroinflammation, and Brain Energy Metabolism. Int J Mol Sci. 2021;22(1):338.
50. 25. Pilozzi A, Carro C, Huang X. Roles of β-Endorphin in Stress, Behavior, Neuroinflammation, and Brain Energy Metabolism. Int J Mol Sci. 2021;22(1):338.
51. 26. Mc Vicar AJ, Greenwood CR, Fewell F, D’Arcy V, Chandrasekharan S, Alldridge LC. Evaluation of anxiety, salivary cortisol and melatonin secretion following reflexology treatment: A pilot study in healthy individuals. Complement Ther Clin Pract. 2007;13(3):137-45.
52. 26. Mc Vicar AJ, Greenwood CR, Fewell F, D’Arcy V, Chandrasekharan S, Alldridge LC. Evaluation of anxiety, salivary cortisol and melatonin secretion following reflexology treatment: A pilot study in healthy individuals. Complement Ther Clin Pract. 2007;13(3):137-45.