Oxidative stress in diabetic pregnancy: SOD, CAT and GSH-Px activity and lipid peroxidation products.

Diabetic pregnancy is often complicated by a number of pathological conditions among which is increased oxidative stress. This study was conducted to investigate the parameters of oxidative stress in 90 patients divided into the three groups: pregnant women with Type 1 diabetes mellitus, healthy pregnant women and non-pregnant women. In pregnancy groups all parameters were followed in 1st, 2nd and 3rd trimester. Diabetic control was monitored by fasting blood glucose and glycosylated hemoglobin (HbA(1c)) and these values, as well as measured biochemical parameters (urea, creatinine, total cholesterol and uric acid), were appropriate throughout the study. The concentration of TBARS, as a measure of lipid peroxidation, and activity of antioxidant enzymes superoxide dismutase (Cu, Zn-SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) were investigated in hemolysate of erythrocytes. TBARS concentration increased significantly in pregnant women when compared with control group (non-pregnant women), as well as in pregnant diabetics compared with healthy pregnant women. The SOD activity was gradually increased in the group of normal pregnant women vs. non-pregnant group, but decreased significantly in the group of diabetic pregnant women. Catalase activity was significantly increased only in 3rd trimester diabetic pregnant women. Increased lipid peroxidation and reduced antioxidant status, despite good diabetic control, show that pregnant women are exposed to oxidative stress to a greater degree than controls.     

Oxidant release is dramatically increased by elevated glucose concentrations in neutrophils from pregnant women.

OBJECTIVE: To evaluate the mechanism of oxidative stress at glucose levels accompanying diabetic pregnancy. Specifically, we hypothesize that elevated glucose overwhelms hexose monophosphate shunt (HMS) down-regulation observed during pregnancy. METHODS: Peripheral blood cells from normal healthy pregnant women were exposed to heightened glucose levels to provide an in vitro model of the effects of diabetic pregnancy. Changes in NAD(P)H, reactive oxygen species (ROS) and nitric oxide (NO) production were evaluated in single cells. RESULTS: Altered metabolic dynamics, as judged by NAD(P)H autofluorescence of neutrophils from both pregnant and non-pregnant women, were observed during incubation with 14 mM glucose, a pathophysiologic level. In parallel, increased production of ROS and NO was observed. The ROS and NO levels attained in cells from pregnant women were greater than those observed in cells from non-pregnant women. Inhibitors of the HMS and NAD(P)H oxidase blocked these effects. These metabolic and oxidant changes required approximately one minute, suggesting that transient glucose spikes during pregnancy could trigger this response. CONCLUSIONS: Elevated glucose levels enhance HMS activity and oxidant production in cells from pregnant women. This mechanism may be generally applicable in understanding the role of diabetes in materno-fetal health.     

Effect of thermal stress on serum prolactin, cortisol and plasma arginine vasopressin concentration in the pregnant and non-pregnant state.

The thermal responses of serum prolactin, cortisol and plasma arginine vasopressin were studied on pregnant and non-pregnant women. Group I consisted of 15 healthy non-pregnant women, group II of 23 women 13-14 weeks pregnant and group III of 23 women 36-37 weeks pregnant. Blood samples were taken before the stress (21-23 degrees C), at the end of a 20 min stay in a heat chamber (70 degrees C, 15% relative humidity) and 20 min and 45 min after the stress (21-23 degrees C). The rectal temperature increased 0.3-0.4 degrees C. Serum concentration of prolactin increased from the pre-stress level by 82% in group I (NS), by 25% in group II (P less than 0.05) by the end of the stress but declined steadily in group III by 12% till the end of the recovery period (P less than 0.001). The cortisol concentration increased only in group II during the recovery period (54-72%, P less than 0.05). In this group the subjects who felt discomfort after the stress had higher cortisol levels already before the stress. Arginine vasopressin levels increased significantly only in group I by 17% (P less than 0.05) and there were no differences in the proportional changes between the groups. The response of prolactin to thermal stress seems to be abolished at late pregnancy while the responses of cortisol and arginine vasopressin are not influenced by pregnancy.     

The effects of pregnancy on the cardiovascular response to acute systemic isocapnic hypoxia in conscious sheep

OBJECTIVE: This study tested the hypothesis that pregnancy affects the cardiovascular responses to hypoxia by altering the outputs of the peripheral components of the stress system and independent of changes in P(a)CO(2). DESIGN: Comparison of cardiovascular and endocrine responses to acute isocapnic hypoxia between pregnant and non-pregnant ewes. SETTING: Experimental laboratory. SAMPLE: Fifteen pregnant (118 days of gestation; term is ca. 145 days) and 8 non-pregnant sheep. METHODS: Chronically instrumented pregnant and non-pregnant ewes were subjected to 1 hour normoxia, 1 hour of acute systemic isocapnic hypoxia and 1 hour recovery. MAIN OUTCOME MEASURES: Arterial blood pressure, heart rate, femoral blood flow and femoral vascular conductance were recorded continuously throughout and arterial blood samples were taken during normoxia, hypoxia and recovery for the measurement of blood gas, metabolic and endocrine status. RESULTS: Basal blood pressure and blood glucose and lactate concentrations were lower in pregnant animals (P < 0.05). In contrast, basal cardiovascular variables and plasma concentrations of noradrenaline, adrenaline, neuropeptide Y, adrenocorticotropic hormone (ACTH) and cortisol were similar in pregnant and non-pregnant ewes. During hypoxia similar reductions in P(a)O(2) occurred in pregnant and non-pregnant animals, without alterations in P(a)CO(2) or pH(a). In non-pregnant ewes, acute hypoxia induced a transient increase in arterial pressure and sustained tachycardia without significant changes in femoral haemodynamics. Pregnancy attenuated the cardiovascular response, significantly diminishing the magnitude of the increment in heart rate throughout the hypoxic challenge (P < 0.001). However, hypoxia did not induce significant changes in blood metabolites or in plasma concentrations of any stress hormone measured in either pregnant or non-pregnant animals. CONCLUSION: Pregnancy not only affects basal but also stimulated cardiovascular function in the mother. The diminished chronotropic response to hypoxia in pregnancy is mediated via mechanisms independent of changes in P(a)CO(2) or in plasma concentrations of hormones or metabolites associated with activation of the stress system.     

Inositol phosphoglycan putative insulin mediator in human amniotic fluid.

BACKGROUND: Many hormones such as insulin, insulin-like growth factors, and the glucocorticoids are involved in regulating fetal growth. Inositol phosphoglycans (IPGs), a family of putative second messengers of insulin, are reported to exert several of insulin's metabolic effects. METHODS: A prospective cross-sectional study was carried out to investigate IPG P-type (P-IPG) in human amniotic fluid and in adult urine under physiological conditions. An amniotic fluid sample was taken from 78 women undergoing early amniocentesis and a mid-stream urine specimen was collected from 109 healthy pregnant and 66 non-pregnant women. All samples were assessed using a polyclonal antibody-based ELISA. RESULTS: The P-IPG content was a thousand times higher in the amniotic fluid than in the urine (p < 0.0001). Urinary specimens showed a four-fold higher P-IPG content during pregnancy than in healthy non-pregnant women (p < 0.001). CONCLUSIONS: Under physiological conditions, human amniotic fluid was found to be enriched in P-IPG compared with maternal urine, suggesting a possible fetal origin. Therefore, IPGs may play a role in insulin sensitivity and fetal growth and, perhaps, be involved in some of its abnormalities such as macrosomia and intrauterine growth restriction.     

Lymphocytic progesterone receptors in normal and pathological human pregnancy

The progesterone receptor-specific monoclonal antibody (MoAb) mPRI was tested for its reactivity towards peripheral blood lymphocytes (PBL) of 49 healthy pregnant women, nine pregnant women with clinical symptoms of threatened preterm delivery, seven women with recurrent spontaneous abortion, ten women in labour and ten women with spontaneous abortion. Lymphocytes of 12 healthy age-matched non-pregnant volunteers were used as controls. Lymphocytes of nine healthy pregnant women at the 1st trimester of pregnancy and those of two non-pregnant donors were tested for the presence of estrogen and progesterone receptors by enzyme immunoassay. PBL of healthy pregnant women contained significantly more positive cells than those of non-pregnant controls. Furthermore, the number of receptor-containing cells increased in parallel with gestational age. In blood samples drawn during labour, as well as in those obtained from women with spontaneous abortion or clinical symptoms of threatened pre-term delivery, the percentage of positively stained lymphocytes was significantly lower than normal pregnancy values. This was also the case in peripheral blood of pregnant women with a history of recurrent spontaneous abortions.     

Plasma concentrations of motilin and somatostatin are increased in late pregnancy and postpartum.

OBJECTIVE: To examine plasma levels of motilin and somatostatin throughout pregnancy. DESIGN: Prospective observational study. SETTING: University Hospital, Norway. SUBJECTS: Eight healthy pregnant women (aged 24-38 years) six of them primigravidae and eight healthy non-pregnant women of similar age with ovulatory menstrual cycles. INTERVENTIONS: In the pregnant women blood samples were obtained at 4-week intervals from 8 weeks gestation throughout pregnancy and again at 5 days and 28 days postpartum. In the non-pregnant controls blood samples were obtained on cycle days 4, 7, 10, 13, 14, 15, 18, 21 and 24. MAIN OUTCOME MEASURES: Plasma levels of motilin and somatostatin. RESULTS: Plasma concentrations of both motilin and somatostatin rose continuously during pregnancy, and motilin levels increased still further to a peak of 165.1 (SE 35.8) pmol/l at 5 days postpartum. Plasma motilin levels were significantly higher during the third trimester and at 5 days postpartum compared with non-pregnant controls (P less than 0.0001). The highest plasma somatostatin levels were found at 40 weeks gestation and at 5 days postpartum (mean 32.1 SE 1.1 pmol/l). Somatostatin levels were significantly higher during the second and third trimester and the postpartum period compared with levels in the follicular phase of the non-pregnant controls (P less than 0.0001). CONCLUSIONS: Circulating levels of motilin cannot play a major role in the relaxation of the gut in pregnancy, but somatostatin may play a part in regulating motility.     

Oxidized low-density lipoprotein and adiponectin levels in pregnancy

Introduction.?The aim of the present study was to investigate whether normal pregnancy represents a complex state of oxidative stress, inflammation and insulin resistance.

Subjects and methods.?One hundred and six pregnant women, between 24th and 28th week of pregnancy (age 27.9?±?0.4 years) (study group) and one hundred and six age-matched, healthy, non-pregnant women (control group) participated in the study. Serum levels of glucose, insulin, adiponectin, oxidized LDL (oxLDL) and lipid parameters, i.e. total cholesterol (TC), triglycerides (TG), HDL and LDL, were determined. Body mass index (BMI) and QUantitative Insulin sensitivity ChecK Index (QUICKI) were also calculated.

Results.?Pregnant women presented higher BMI values, insulin and oxLDL serum levels and lower glucose serum levels than controls. Serum levels of lipids (TC, TG, LDL and HDL) were higher in pregnant women. There was a significant positive correlation of oxLDL to adiponectin (p?<?0.01) in the study group, but not in the controls, and no other significant correlation with any of the other parameters, in either of groups.

Conclusions.?Pregnancy is a state of insulin resistance, oxidative stress and pro-atherogenic hyperlipidemia. Adiponectin may, though, have cardioprotective role in pregnant women.     

Role of tumour necrosis factor-alpha in insulin resistance during normal pregnancy

OBJECTIVE: Role of tumour necrosis factor-alpha (TNF-alpha) was studied in insulin resistance during pregnancy. STUDY DESIGN: Serum TNF-alpha (ELISA) and fasting C-peptide (Cp) (RIA) concentrations were measured in 40 healthy pregnant women (15, 12 and 13 of them in the 1st, 2nd and 3rd trimesters, respectively) and in 25 healthy non-pregnant women in a case-control study. RESULTS: TNF-alpha (X+/-S.D.: 5.33+/-0.46 pg/ml) and Cp levels (3.37+/-1.30 ng/ml) were significantly higher in the 3rd trimester as compared with matched healthy controls (TNF: 4.07+/-0.26, Cp: 1.05+/-0.36) and to the pregnant women in 1st (TNF: 4.04+/-0.26, Cp: 1.34+/-0.59) and 2nd (TNF: 4.35+/-0.32, Cp: 1.11+/-0.35) trimesters. Significant positive linear correlation was calculated among TNF-alpha, Cp, Cp/blood glucose ratio (indirect parameters of insulin resistance) and body mass indexes (BMIs) of pregnant women (P<0.01). CONCLUSION: TNF-alpha may contribute to the insulin resistance during the course of normal pregnancy.     

Effect of labor on maternal dehydration, starvation, coagulation, and fibrinolysis.

BACKGROUND: Dehydration, starvation, and enhanced blood coagulability may occur during labor. METHODS: We studied 60 women who gave birth vaginally to a healthy singleton infant at term. Sampling of urine and blood specimens was performed on admission to the hospital with labor pains and just after birth. Paired samples were available from 50 women for urine analysis and 29 women for blood analysis. Total fluid intake (oral and intravenous) during labor was recorded. Changes in various parameters in the urine and blood in relation to the total fluid intake were analyzed. RESULTS: Osmolality and creatinine concentration in the urine, red blood cell count, hemoglobin concentration, hematocrit value, thrombin-antithrombin III complex, plasmin-alpha 2-plasmin inhibitor complex and D dimer significantly increased during labor. Ketone bodies were absent in the urine in 84% (42/50) of women on admission to the hospital whereas these were present in 74% (37/50) of women just after delivery (p < 0.01). The degree of these changes appeared to be smaller with an increase in fluid intake. CONCLUSION: Concentrated urine, hemoconcentration, starvation, and activation of the thrombogenic and fibrinolytic system occur in parturient women. Sufficient fluid intake during labor may ameliorate these unfavorable changes.     

Echocardiography during pregnancy--longitudinal studies in primigravidae

As a result of hormonal changes processes of adaptation of the cardio-vascular system occur during pregnancy. These regulative changes are the basis for the present echo-cardiographic study which was made under standardized conditions with healthy primigravidae (n = 20) compared to nulligravidae (n = 24). Besides blood pressure and heart frequency dimension and volume sizes of the left ventricle (LV) as well as the LV-weight of muscle and the peripheral vascular resistance were analysed. As result significant increases from the 15th to the 35th week of pregnancy (SSW) could be found for the following parameters: heart frequency, arterial blood pressure, endosystolic volume of the left ventricle, cardiac output, left ventricular weight of muscle (p less than 0.01) endosystolic diameter of the left ventricle, enddiastolic volume of the left ventricle and heart index (p less than 0.05). The peripheral resistance was continuously decreased in the course of pregnancy (p less than 0.01). Compared to non-pregnant women the following parameters showed significantly higher values: heart frequency, cardiac output and heart index (p less than 0.01). The peripheral resistance was significantly lower in pregnant women compared to non-pregnant women (p less than 0.01). From the results the conclusion can be drawn that with statistic certainty echocardiography records adaptive processes of the circulation regulation relative to pregnancy and enables a separation in the groups of pregnant and non-pregnant women.     

Lack of effect of psychosocial stress on maternal corticotropin-releasing factor and catecholamine levels at 28 weeks' gestation

OBJECTIVE: Corticotropin-releasing factor (CRF) and catecholamines are among the major hormones activated during the adaptive response to stressful stimuli. In pregnant women, serum CRF and catecholamines levels increase during labor and preterm delivery. The aim of the present study was to evaluate whether psychosocial stress measures are correlated with serum CRF or urinary catecholamine [ie, epinephrine, norepinephrine (NE), dopamine (DA)] levels in healthy midtrimester pregnant women. METHODS: A large group of white pregnant women (n = 382) participated in the present study. The Work Conditions Questionnaire and the Psychiatric Epidemiology Research Interview were administered to measure job stress and general life stress, respectively. Urine and blood specimens were collected at 28 weeks of gestation at the time of psychosocial evaluation. Epinephrine, NE, and DA were quantified in the urine by a highly sensitive method based on an amperometric detector. Serum CRF and cortisol levels were measured in blood specimens by using specific radioimmunoassays. RESULTS: Serum CRF and cortisol levels did not vary between patients with high and low scores on psychological tests, and no correlation was found between CRF and cortisol levels. One job stress measure, low job latitude, was significantly associated with a mild increase in NE and DA levels in the afternoon and night (P < .05, analysis of variance). Serum cortisol levels were inversely correlated with NE in the morning (r = -0.447; P =.002) and night segments (r = -0.391; P = .007) and with DA in the night period (r = -0.367; P = .013). CONCLUSION: The absence of a significant relationship between CRF/cortisol and psychosocial stress measures in pregnant women suggests that the hypothalamic-pituitary-adrenal response to psychosocial stress may be masked at midtrimester by the constantly high levels of placental CRF, whose control is beyond the influence of environmental stressors.     

Maternal and fetal serum nitric oxide (NO) concentrations in normal pregnancy, pre-eclampsia and eclampsia.

OBJECTIVES: To measure the maternal and fetal serum concentrations of total nitrites and nitrates (as an index of nitric oxide production) in normal pregnancy, pre-eclampsia and eclampsia. DESIGN: Three groups of women were studied cross-sectionally: late pregnant women with pre-eclampsia and eclampsia (n=31); normal late pregnant women (n=32); and age-matched healthy non-pregnant women (n=21). Venous blood samples were collected from all women and both maternal and umbilical venous samples were collected from pregnant women. METHODS: Blood samples were assayed for nitric oxide (NO) production by Greiss reaction which measures the combined oxidation products of NO (total nitrites and nitrates). RESULTS: There was a significant increase in serum total nitrites and nitrates concentrations in normal pregnant women than in the serum of age-matched normal non-pregnant women (P<0.0001). Significantly higher total nitrites and nitrates levels were found in the maternal sera of the pre-eclamptic and eclamptic women compared with those of normal pregnant women (P<0.0001). Also, fetal blood levels of total nitrites and nitrates were significantly increased in pre-eclampsia and eclampsia compared with those of normal pregnancy (P<0.0001). CONCLUSIONS: (1) Serum nitric oxide (NO) production is increased in normal pregnancy than in the normal non-pregnancy. (2) Maternal and fetal serum NO levels are increased significantly in pre-eclampsia and eclampsia, which possibly represents a compensatory/protective mechanism to maintain blood flow and limit platelets aggregation in the fetal-maternal circulations. (3) The increase in NO production is directly related to the severity of pre-eclampsia; this would be of diagnostic significance for the prediction of the severity of this syndrome.     

妊娠期高血压疾病患者血浆D-二聚体与亮氨酸氨基肽酶的关系

目的:探讨妊娠期高血压疾病(hypertensive disorders complicating pregnancy,HDCP)患者血浆D-二聚体与亮氨酸氨基肽酶(leucine aminopeptidase,LAP)的关系以及临床上的应用价值。方法:选取2015年8月—2016年12月在南平市第一医院产检正常的妊娠妇女404例,经体检未孕健康妇女101例。选取同期在南平市第一医院收治的HDCP妇女116例。检测受试者LAP、碱性磷酸酶(ALP)、D-二聚体﹑尿总蛋白、尿肌酐等,计算尿总蛋白肌酐比(UTPCR)。采用单因素方差分析、Pearson相关分析和趋势图分析D-二聚体与LAP、UTPCR等的关系。结果:HDCP组患者收缩压、D-二聚体浓度和UTPCR高于非妊娠期组和正常妊娠各期组,差异有统计学意义(均P<0.05),LAP浓度低于妊娠晚期组(P<0.05)。妊娠晚期组的D-二聚体浓度仅与UTPCR值呈正相关(r=0.190,P=0.011)。HDCP组患者D-二聚体浓度与孕周和LAP浓度呈负相关(r=-0.505,P=0.000;r=-0.443,P=0.001),与UTPCR值呈正相关(r=0.372,P=0.004)。趋势图显示HDCP组患者血浆D-二聚体浓度高于正常妊娠晚期妇女,血浆LAP浓度低于正常妊娠晚期妇女。结论:HDCP患者血浆D-二聚体与LAP相关性较好,联合检测D-二聚体和LAP,结合UTPCR对HDCP早期发现、治疗及预防有重要临床价值。     

WISP1 is a novel adipokine linked to metabolic parameters in gestational diabetes mellitus

Objective: To investigate Wnt1-inducible signaling pathway protein-1 (WISP1) levels and their correlation with metabolic parameters in pregnant women with gestational diabetes mellitus (GDM) and non-GDM healthy pregnant women.

Materials and Methods: In this prospective cross-sectional study, the study group was composed of 62 women with GDM and 73 healthy pregnant women matched for age, body mass index (BMI) and gestational age. Blood samples were collected at 25–29th gestational week. Serum WISP1, betatrophin, glucose, fasting insulin, glycosylated hemoglobin A1c, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, C reactive protein, alanine aminotransferase and creatinine levels were measured. Homeostasis model assessment of insulin resistance (HOMA-IR) values was calculated. The level of significance was accepted as p?Results: Circulating WISP1 in the GDM group was significantly higher than the control group (p?<0.001). Further, WISP1 was positively correlated with BMI, HOMA-IR values and fasting glucose, fasting insulin, triglyceride, betatrophin levels. BMI, HOMA-IR and betatrophin independently and positively predicted WISP1 levels.

Conclusion: These results demonstrate a relationship between WISP1 and the metabolic parameters of GDM. And, WISP1 might be involved in the pathophysiology of GDM. As a part of this pathophysiological mechanism, the activation of WISP1 and betatrophin might take place through several ways; WISP1 and betatrophin might either use same signaling pathways and potentiate each other or they might also constitute the sequential steps of a common pathway.     

Leptin and pre-eclampsia in black African parturients

Objective To measure serum concentrations of the hormone leptin during late pregnancy in Black African women with pre-eclampsia, healthy normotensive pregnant women as controls and healthy normotensive non-pregnant women; secondly, to explore the relationship between leptin and obesity.
Design Observational, cross sectional study.
Setting Antenatal clinics, antenatal wards, gynaecology out patient and family planning clinics of a tertiary hospital, Durban, South Africa.
Population Pregnant and non-pregnant Black African women.
Method Serum leptin was measured by a homologous radio-immunoassay technique. Simple anthropometric parameters were used to explore the relationship between leptin and obesity. In each group, leptin levels were compared between obese (body mass index,  BMI ≥ 30 kg m⁻²  ) and lean women.
Main outcome measures Serum leptin concentrations, anthropometric parameters, mean blood pressures and proteinuria.
Results There were 68 women with pre-eclampsia, 92 healthy normotensive pregnant women (controls) and 32 healthy normotensive non-pregnant women. Serum leptin levels were higher in pregnant compared with non-pregnant women [26.66 (1.96) and 25.89 (1.65) vs 17.97 (2.11) ng/mL,   P = 0.02  ]. Weight and BMI showed the greatest correlation with leptin both in pregnant (   r = 0.61 and r = 0.58, respectively  ) and non-pregnant women (   r = 0.74 and 0.79, respectively  ). There was no significant difference in the mean concentrations of leptin between women with and those without pre-eclampsia [26.66 (1.96) vs 25.89 (1.65) ng/mL, respectively,   P = 0.95  ].
Conclusion Pregnancy is a hyperleptinaemic state. There is no difference in serum leptin levels between Black African women with pre-eclampsia and healthy normotensive pregnant women. Serum leptin concentration is largely determined by the degree of adiposity.     

Effect of normal and preeclamptic plasma on superoxide-anion production of neutrophils from healthy non-pregnant women

This study has examined whether production of superoxide-anion by granulocytes differs between non-pregnant, healthy pregnant and preeclamptic pregnant women. First, we assessed superoxide-anion production in 13 non-pregnant women, 11 healthy pregnant women and 14 preeclamptic pregnant women. Then, we examined the effect of plasma samples of healthy pregnant and preeclamptic pregnant women on superoxide production by neutrophils separated from healthy pregnant women. Superoxide generation was measured by ferricytochrome-c reduction. Phorbol-12,13-dibutyrate- and n-formyl-methionyl-leucyl-phenylalanine-stimulated superoxide-anion production was significantly decreased in healthy pregnant women's granulocytes compared with non-pregnant women. There was no significant difference between granulocyte superoxide-anion production in preeclamptic pregnant and non-pregnant women. When neutrophils from non-pregnant women were incubated in plasma from healthy pregnant women, the granulocyte phorbol-12,13-dibutyrate-stimulated superoxide-anion production was significantly inhibited. With the same stimulator, there were no significant differences between superoxide-anion production of neutrophils incubated in autologous, non-pregnant and preeclamptic pregnant plasma. If n-formyl-methionyl-leucyl-phenylalanine was used for stimulation, there were no significant differences in the superoxide-anion production of granulocytes in either group. Granulocyte superoxide-anion production decreases during pregnancy; this decrease does not occur in preeclampsia, and may cause endothelial damage. It is conceivable that there are unidentified factors in maternal circulation which inhibit superoxide-anion production by granulocytes in healthy pregnant women.     

The effect of tobacco smoking during pregnancy on concentration of malondialdehyde in blood of mothers and in umbilical cord blood

OBJECTIVES: Maternal smoking during pregnancy is known to be associated with not only intrauterine fetal growth retardation or low birth weight but also causes disturbances in postnatal growth and development. The prime role of oxidative stress in the pathogenesis of adverse pregnancy outcomes is almost universally accepted. DESIGN: The aim of the study was to estimate the effect of tobacco smoking during pregnancy on concentration of lipid peroxidation products (malondialdehyde - MDA) in blood of mother and newborns. MATERIALS AND METHODS: 147 healthy, pregnant women were divided into non-smoking (n = 85) and smoking group (n = 62) according to questionnaire declaration and confirmed by cotinine concentration in serum and urine. Level of MDA was measured by fluorimetric method in plasma and in erythrocytes of mothers and umbilical cord blood. RESULTS: We found that, in group of women smoking during pregnancy concentration of malondialdehyde was higher in plasma and in erythrocytes when compared to group of tobacco abstinent. Also in cord blood of newborns of smoking mothers level of MDA was significantly higher in plasma (p < 0.05) as well as in erythrocytes (p < 0.01) than in control group. CONCLUSION: The presented results indicate that smoking during pregnancy may promotes free radical damage in growing fetus and newborns therefore stimulates metabolic disorders dependent on oxidative stress.     

Decreased total antioxidant status and increased oxidative stress in women with polycystic ovary syndrome may contribute to the risk of cardiovascular disease

OBJECTIVE: To determine oxidative stress by the level of protein carbonyls and total antioxidant status (TAOS), and whether oxidative stress is associated with increased risk of cardiovascular disease in women with polycystic ovary syndrome (PCOS). DESIGN: Controlled clinical study. SETTING: University hospital. PATIENT(S): Thirty women with PCOS and 31 healthy control women. INTERVENTION(S): Biometric measures and blood samples collection. MAIN OUTCOME MEASURE(S): C-reactive protein (CRP), lipid fractions, glucose, protein carbonyls, insulin, and other hormone (gonadotropins, androgens) levels and TAOS were measured. The estimate of insulin resistance was calculated by homeostasis model assessment (HOMA-R). RESULT(S): The women with PCOS had significantly higher serum fasting insulin, CRP, protein carbonyl levels, HOMA-R, LH levels, and LH/FSH ratios than healthy women. However, TAOS was significantly lower in women with PCOS. TAOS was negatively correlated with fasting insulin, HOMA-R, CRP, and protein carbonyls. Fasting insulin was positively correlated with protein carbonyls. High density lipoprotein (HDL) was inversely associated with fasting insulin, HOMA-R, and protein carbonyls. CONCLUSION(S): Increased oxidative stress and decreased antioxidant capacity may contribute to the increased risk of cardiovascular disease in women with PCOS, in addition to known risk factors such as insulin resistance, hypertension, central obesity, and dyslipidemia.     

Evaluation of the macula,retinal nerve fiber layer and choroid in preeclampsia,healthy pregnant and healthy non-pregnant women using spectral-domain optical coherence tomography

Objective: To evaluate the macular, retinal nerve fiber layer (RNFL) and choroidal thickness alterations by using spectral-domain optical coherence tomography (SD-OCT) in preeclampsia and compare with healthy pregnant and healthy non-pregnant controls. Method: The study population included healthy pregnant control group (n: 25), healthy non-pregnant control group (n: 26) and study group with preeclampsia (n: 27). Retinal thickness parameters were measured by SD-OCT. Results: There was a statistically significant difference among all of the groups for choroidal thickness (p?p?p?p?=?0.004). Conclusions: This study revealed that choroidal thickness measured using SD-OCT increased in women with preeclampsia and healthy pregnant women but the increase in choroidal thickness in preeclampsia was lower than the healthy pregnant controls. This lower rise in choroidal thickness can be generally attributed to the markedly increased systemic vascular vasospasm secondary to preeclampsia.