Impact of intrapartum factors on oxidative stress in newborns

Nabhan, Ashraf; Eldin, Lerine B; Rabie, Ahmed; Fahmy, Gehan

doi:10.1080/14767050902994614

Cited by 13 publications

(9 citation statements)

References 26 publications

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“…Birth weight and gestational age could be important. 49 Surgery-related parameters such as the urgency of delivery, the duration of surgery, and the interval from uterine incision to delivery, are known to influence neonatal outcomes. 50 Maternal inhaled oxygen concentration, minute ventilation, intravenous fluid volume, blood pressure, vasopressor administration and extent of sympathetic block may be more important than the nature of the anesthetic agents.…”

Section: Discussionmentioning

confidence: 99%

Comparison between general, spinal, epidural, and combined spinal-epidural anesthesia for cesarean delivery: a network meta-analysis

Kim

Hur

Park

et al. 2019

International Journal of Obstetric Anesthesia

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Background: This study is a network meta-analysis to compare maternal and fetal outcomes associated with four different anesthetic techniques for cesarean delivery. Methods: An arm-based, random-effects frequentist network meta-analysis was performed. A random effect model was selected considering deviance information criteria. Randomized trials reporting the following outcomes were included: Apgar score at 1-or 5-min; umbilical arterial and venous pH; umbilical arterial pH <7.2; and neonatal score at 2-4 hours. Loop-specific heterogeneity was evaluated by risk of odds ratio and s 2. Quality of evidence was assessed using the GRADE approach. Results: Data from 46 randomized trials including 3689 women contributed to the study. There were significant differences in Apgar score 6 at 1 min between spinal versus general anesthesia (odds ratio 0.27, 95% confidence interval [CI] 0.13 to 0.55: moderate quality evidence) and Apgar scores at 1-and 5-min, favoring spinal anesthesia. Umbilical venous pH associated with epidural anesthesia was significantly higher than that with general anesthesia (mean difference 0.010, 95% CI 0.001 to 0.020: moderate quality evidence) or spinal anesthesia. Spinal anesthesia was ranked best for Apgar score 6 at 1-min (SUCRA=89.8), Apgar score at 1-min (SUCRA=80.4) and 5-min (SUCRA=90.5). Epidural anesthesia was ranked highest for umbilical venous pH (SUCRA=87.4) and neonatal score (SUCRA=79.3). Conclusions: Spinal and epidural anesthesia were ranked high regarding Apgar scores and epidural anesthesia was ranked high regarding umbilical venous pH, but the results were based on small heterogeneous studies with high or unclear risks of bias.

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Section: Discussionmentioning

confidence: 99%

Comparison between general, spinal, epidural, and combined spinal-epidural anesthesia for cesarean delivery: a network meta-analysis

Kim

Hur

Park

et al. 2019

International Journal of Obstetric Anesthesia

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“…4a-OHC is known to be formed by cholesterol autoxidation [9][13] during oxidative stress, but it is not known if it can be formed enzymatically as well. There are inconsistencies in the literature on the oxidative effect on mother and child by uncomplicated vaginal delivery or CS [34][35][36][37][38][39][40][ [39][40][41][42][43][44][45], possibly due to the use of different markers.…”

Section: Discussionmentioning

confidence: 99%

Cytochrome P450 3A activity in mothers and their neonates as determined by plasma 4β-hydroxycholesterol

Nylén

Sergel

Forsberg

et al. 2011

Eur J Clin Pharmacol

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PurposeThe purpose of this study was to determine the 4 -hydroxycholesterol to cholesterol ratio in mothers and neonates at the time of birth and four months post partum.Method 21 mothers and 22 neonates were recruited at the delivery ward at Karolinska University Hospital, Huddinge,Sweden. Blood samples taken from mothers and neonates at birth and four months post partum were analyzed for 4 -hydroxycholesterol and cholesterol. ResultsThe median plasma concentration of 4 -hydroxycholesterol was higher in mothers at delivery (50 ng/mL) compared to healthy non-pregnant women (29 ng/mL). The pregnant women had a higher median cholesterol concentration (6.2 mmol/L) compared to healthy non-pregnant women (4.6 mmol/L) but this could only partly explain the increased 4 -hydroxycholesterol. The major cause is an increased CYP3A activity during pregnancy. The median 4 -hydroxycholesterol/cholesterol ratio•10 4 was elevated in mothers at time of birth compared to non-pregnant women (0.19 and 0.15, respectively) but decreased to 0.15 four months post partum.Neonates had a median 4 -hydroxycholesterol/cholesterol ratio•10 4 (0.19) comparable to adults already at birth, but lower 4 -hydroxycholesterol (12 ng/mL) and cholesterol (1.8 mmol/L) concentrations. ConclusionPregnancy leads to increased CYP3A enzyme activity as determined by the 4 -hydroxycholesterol/cholesterol ratio. Neonates have low 4 -hydroxycholesterol and cholesterol concentrations but similar total CYP3A activity as adults already at birth.

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“…Correlation analysis revealed that blood level of MDA of both mother and cord blood correlated negatively with birth weight of the neonates. Malondialdehyde levels in fetal serum have previously also been shown to correlate negatively with fetal weight [24]. Total antioxidant capacity of blood in both mother and fetus correlated positively with fetal weight, indicating significant impact of antioxidant potential on fetal birth weight, and thus, the incidence of FGR.…”

Section: Discussionmentioning

confidence: 89%

Idiopathic Fetal Growth Restriction: Repercussion of Modulation in Oxidative Stress

et al. 2015

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Oxidative stress has been proposed as one of the causes involved in idiopathic fetal growth restriction (IFGR). However, the exact relationship between oxidative stress and IFGR is not understood. This study aimed at understanding the role of oxidative stress and antioxidant status in IFGR materno-fetal dyads and matched controls. 75 materno-fetal dyads with IFGR were enrolled with equal number of normal low risk controls. Malondialdehyde (MDA) levels were measured as marker of oxidative stress, while paraoxonase-1 (PON1) activity and total antioxidant capacity (TAC) of serum were measured as markers of antioxidant status. MDA levels were increased in both maternal and cord blood of IFGR neonates as compared to controls (p \ 0.001). TAC of serum were found to be decreased in IFGR (both maternal and cord blood) as compared to controls (p \ 0.001; p \ 0.05, respectively). PON1 activity was found to be decreased in the IFGR mothers while it was found increased in IFGR cord blood (p \ 0.01; p \ 0.001)). IFGR is a state of increased oxidative stress. Decreased PON1 enzymatic activity in mothers is also associated with IFGR.

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Impact of intrapartum factors on oxidative stress in newborns

Abstract: The oxidative status of the newborn is not simply a reflection of the mode of delivery and type of anesthesia. The impact of gestational age and birth weight appears to be crucial. This must be considered when planning elective delivery.

Cited by 13 publications

References 26 publications

Comparison between general, spinal, epidural, and combined spinal-epidural anesthesia for cesarean delivery: a network meta-analysis

Comparison between general, spinal, epidural, and combined spinal-epidural anesthesia for cesarean delivery: a network meta-analysis

Cytochrome P450 3A activity in mothers and their neonates as determined by plasma 4β-hydroxycholesterol

Idiopathic Fetal Growth Restriction: Repercussion of Modulation in Oxidative Stress

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