THE EFFECT OF DELIVERY MODE ON NT-PROBNP LEVELS IN NEWBORNS

Öz

Objective: Reference values of NT-proBNP levels in newborns may vary depending on gestational age, postnatal age and Apgar scores. However, the effect of the mode of delivery has been less investigated, and the results are contradictory. In this study, it was aimed to compare NT-proBNP levels in healthy term newborns born through vaginal delivery and cesarean (C/S) and to investigate whether delivery method had an effect on it. Material and Methods: Healthy newborns born in our hospital and with a gestational age of ≥38 weeks were included in the study. Cases (n=56) were grouped according to delivery type. Both groups were similar in terms of gender, gestational age, body weight and Apgar scores. NT-proBNP levels, hematological parameters, LDH and CPK levels were studied in blood samples taken in the first hours after birth. The two groups were compared in terms of these parameters and it was investigated whether there was a relationship between the parameters. Results: NT-proBNP levels were 3145 (372-7231) pg/ml in newborns born vaginally and 783 (401-6563) pg/ml in newborns born by cesarean section (p<0.05). CPK, LDH levels and white blood cell counts were higher in newborns born by vaginal delivery compared to newborns born by cesarean section (p<0.05). In addition, a positive correlation was found between NT-proBNP values and white blood cell counts (r =0.6, p=0.000). Conclusion: NT-proBNP levels of those born vaginally are in the range of predefined reference levels and increased 4 times compared to those born through C/S. In addition, the relationship between NT-proBNP levels and biochemical markers and white blood cell counts suggests that vaginal delivery causes physiological stress and this may be related to postpartum adaptation.

Anahtar Kelimeler

• NT-proBNP
• newborn
• mode of delivery

Doğum Şeklinin Yenidoğanlarda NT-ProBNP Düzeylerine Etkisi

Öz

Amaç: Yenidoğanlarda NT-proBNP düzeylerinin referans değerleri gebelik yaşı, postnatal yaş ve Apgar skorlarına bağlı olarak değişebilmektedir. Ancak, doğum şeklinin NT-proBNP düzeyleri ile ilişkili olup olmadığı halen belirsizdir. Bu nedenle çalışmamızda, vajinal doğum veya sezaryen sonrası doğan sağlıklı term yenidoğanlarda NT-proBNP düzeylerinin karşılaştırılması amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya hastanemizde doğan ve ğgestasyonel yaşı ≥38 hafta olan sağlıklı bebekler dahil edildi. Olgular (n=56) doğum şekline göre gruplandırıldı. Her iki grup cinsiyet, gebelik yaşı, vücut ağırlığı ve Apgar skorları açısından benzerdi. Doğum sonrası ilk saatlerde alınan kan örneklerinde NT-proBNP düzeyleri, hematolojik parametreler, LDH ve CPK düzeyleri çalışıldı. İki grup bu parametreler açısından karşılaştırıldı ve parametreler arasında ilişki olup olmadığı araştırıldı. Bulgular: Vajinal yolla doğan bebeklerde NT-proBNP seviyeleri 3145 (372-7231) pg/ml ve sezaryen ile doğan bebeklerde 783 (401-6563) pg/ml idi (p<0.05). Vajinal yolla doğan bebeklerde sezaryen ile doğanlara göre CPK, LDH düzeyleri ve beyaz küre sayıları daha yüksekti (p<0.05). Ayrıca, NT-proBNP değerleri ile beyaz küre sayıları arasında pozitif korelasyon saptandı (r =0.6, p=0.000). Sonuç: Vajinal yolla doğan yenidoğanlarda NT-proBNP düzeylerinin sezaryen ile doğanlara göre önceden tanımlanmış referans değer aralıkları içinde olduğu ve 4 kat arttığı görülmektedir. Ayrıca, NT-proBNP düzeyleri ile biyokimyasal belirteçler ve beyaz kan hücresi sayıları arasındaki ilişki, vajinal doğumun fizyolojik strese neden olduğunu ve bunun doğum sonrası adaptasyonla ilgili olabileceğini düşündürmektedir.

Anahtar Kelimeler

• NT-proBNP
• yenidoğan
• doğum şekli

Kaynakça

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