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

Öz

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.

Anahtar Kelimeler

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

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

Öz

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.

Anahtar Kelimeler

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

Kaynakça

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