Doğum Şeklinin Umbilikal Kord Kanındaki Tiyol-Disulfid Dengesine Etkisi

Abstract

Amaç: Günümüzde, oksidatif stress seviyesi sıklıkla thiol-disufid dengesini inceleyen metodlar yoluyla saptanır. Elektif sezaryen (ES) ve vajinal doğumlardaki (VD) oksidatif stresi tihol-disulfid dengesini inceleyerek karşılaştırmayı amaçladık.

Araçlar ve Yöntem: Çalışmaya 48 VD ve 57 ES dahil edildi. Çalışmada, standardizasyon amacıyla, spinal anestezi ile yapılan ES’lar incelendi. Plasenta ayrıldıktan hemen sonra umblikal arterden beş mililitre kan örneği alındı. Serum nativ thiol, total thiol, disulfid analiz edildi. Disulfid/nativ thiol (%), disulfid/total thiol (%), and nativ thiol/total thiol (%) oranları hesaplandı.

Bulgular: ES grubundaki nativ thiol, total thiol, disulfid, and disulfid/total thiol oranları VD grubundan belirgin olarak düşüktü (446.27±48.01 , 484.26±47.50, p<0.001, 493.28±69.14 , 541.43±64.21, p<0.001, 23.75±9.27 , 28.58±11.11, p=0.017 ve 4.68±1.48 , 5.80±2.04, p= 0.002, sırasıyla). Gruplar arasında disulfid/nativ thiol ve nativ thiol/total thiol oranları bakımından farklılık yoktu (p>0.05). Gruplar arasında yaş ortalaması, doğum haftası ve doğum ağırlığı açısından fark yoktu (p>0.05). ES grubundaki yenidoğanların ilk ve 5. dakika Apgar skorları VD grubundan daha yüksekti (p<0.01).

Sonuç: Thiol-disulfit dengesi doğum yönteminden etkilenmektedir. Vajinal doğumdaki oxidativ stres seviyesi elektif sezaryendekinden daha yüksektir.

Keywords

• sezeryan
• disülfit
• oksidatif stres
• tiyol
• vajinal doğum

The Effect of Delivery Mode on Thiol-Disulfide Balance in the Umbilical Cord Blood

Abstract

Purpose: Today, the Oxidative stress level is frequently determined through the methods examining the thiol-disulfide balance. We aimed to compare oxidative stress in elective caesarean sections (ECS) and vaginal deliveries (VD) by examining the thiol-disulfide balance.

Materials and methods: Forty- eight VDs and 57 ECSs were included in the study. For standardization, pregnant women who underwent spinal anesthesia for ECS were examined in the study. Five milliliter of blood samples were taken from the umbilical artery immediately after placenta delivery. Serum native thiol, total thiol, disulfide was analyzed in blood samples. Disulfide/native thiol (%), disulfide/total thiol (%), and native thiol/total thiol (%) ratios were calculated.

Results: Native thiol, total thiol, disulfide, and disulfide/total thiol ratios were significantly lower in the ECS group than in the VD group (446.27±48.01 vs 484.26±47.50, p<0.001, 493.28±69.14 vs 541.43±64.21, p<0.001, 23.75±9.27 vs. 28.58±11.11, p=0.017, and 4.68±1.48 vs 5.80±2.04, p= 0.002, respectively). There were no differences between the groups in terms of disulfide/native thiol, and native thiol/total thiol ratios (p>0.05). There were no differences between the groups in terms of mean age, gestational week, and birth weight (p>0.05). First and 5th Apgar scores of the newborn of the ECS group were higher than the VD group (p<0.01).

Conclusion: The thiol-disulfide balance is affected by delivery mode. The oxidative stress level in vaginal deliveries is higher than in elective caesarean sections.

Keywords

• caesarean section
• disulfides
• oxidative stress
• thiols
• vaginal delivery

References

1. 1. Arasimowicz M, Floryszak-Wieczorek J, Milczarek G, Jelonek T. Nitric oxide, induced by wounding, mediates redox regulation in pelargonium leaves. Plant Biol (Stuttg) 2009;11(5):650-663.
2. 2. Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem. 2014;47(18):326-332.
3. 3. Burton GJ, Jauniaux E. Oxidative stress. Best Pract Res Clin Obstet Gynaecol. 2011;25(3): 287-299.
4. 4. Kundi H, Erel O, Balun A, et al. Association of thiol/disulfide ratio with syntax score in patients with NSTEMI. Scand Cardiovasc J. 2015;49(2):95-100.
5. 5. Ergin M, Cendek BD, Neselioglu S, Avsar AF, Erel O. Dynamic thiol-disulfide homeostasis in hyperemesis gravidarum. J Perinatol. 2015;35(10):788-792.
6. 6. Korkmaz V, Kurdoglu Z, Alisik M, et al. Impairment of thioldisulfide homeostasis in preeclampsia. J Matern Fetal Neonatal Med. 2016;29(23):3848-3853.
7. 7. Onat T, Kırmızı DA, Başer E, et al. The relationship between oxidative stress and preeclampsia. The serum ischemiamodified albumin levels and thiol/disulfide homeostasis. Turk J Obstet Gynecol. 2020;17(2):102-107.
8. 8. Lurie S, Matas Z, Boaz M, Fux A, Golan A, Sadan O. Different degrees of fetal oxidative stress in elective and emergent cesarean section. Neonatology. 2007;92(2):111-115.

9. 9. Vakilian K, Ranjbar A, Zarganjfard A, et al. On the relation of oxidative stress in delivery mode in pregnant women; a toxicological concern. Toxicol Mech Methods. 2009;19(2):94-99.
10. 10. Wang M, Liang Q, Li H, et al. Normal pregnancy-induced amino acid metabolic stress in a longitudinal cohort of pregnant women: novel insights generated from UPLC-QTOFMS-based urine metabolomic study. Metabolomics. 2016;12(8):131.
11. 11. Kacerovsky M, Tothova L, Menon R, et al. Amniotic fluid markers of oxidative stress in pregnancies complicated by preterm prelabor rupture of membranes. J Matern Fetal Neonatal Med. 2015;28(11):1250-1259.
12. 12. Aksoy AN, Gözükara I, Kucur SKl, Batmaz G, Laloğlu E, Bulut E. Spontan vajinal doğum yapan hastalarda maternal serum beyin kaynaklı nörotrofik faktör ve malondialdehit düzeylerindeki değişimlerin araştırılması. Zeynep Kamil Tıp Bül. 2015;46(1):6-12.
13. 13. Hung TH, Chen SF, Lo LM, Li MJ, Yeh YL. The associations between labor and delivery mode and maternal and placental oxidative stress. Reprod Toxicol 2011;31(2):144-150.
14. 14. Ulubas Isik D, Akdas Reis Y, Bas AY, et al. The effect of the modes of delivery on the maternal and neonatal dynamic thiol-disulfide homeostasis. J Matern Fetal Neonatal Med. 2019;32(23):3993-3997.
15. 15. Yalcin S, Aydogan H, Kucuk A, et al. Supplemental oxygen in elective cesarean section under spinal anesthesia: Handle the sword with care. Braz J Anesthesiol. 2013;63(5):393-397.
16. 16. Kulacoglu H, Ozdogan M, Gurer A, et al. Prospective comparison of local, spinal, and general types of anaesthesia regarding oxidative stress following Lichtenstein hernia repair. Bratisl Lek Listy. 2007;108(8):335-339.
17. 17. Cindrova-Davies T, Yung HW, Johns J, et al. Oxidative stress, gene expression, and protein changes induced in the human placenta during labor. Am J Pathol. 2007;171(4):1168-1179.
18. 18. Parmigiani S, Payer C, Massari A, Bussolati G, Bevilacqua G. Normal values of reactive oxygen metabolites on the cordblood of full-term infants with a colorimetric method. Acta Biomed Ateneo Parmense. 2000;71(1-2):59-64.
19. 19. Chiba T, Omori A, Takahashi K, et al. Correlations between the detection of stress‐associated hormone/oxidative stress markers in umbilical cord blood and the physical condition of the mother and neonate. J Obstet Gynaecol Res. 2010;36(5):958-964.