Download PDF
Horm Metab Res 2001; 33(4): 227-231
DOI: 10.1055/s-2001-14953
Original Clinical
© Georg Thieme Verlag Stuttgart · New York

Lipid Peroxidation, Antioxidant Defence and Acid-Base Status in Cord Blood at Birth: The Influence of Diabetes

M. Kinalski1 , A. Śledziewski2 , B. Telejko3 , I. Kowalska3 , A. Krętowski3 , W. Zarzycki3 , I. Kinalska3
  • 1 Department of Pathophysiology of Pregnancy, Medical Academy Białystok, Poland
  • 2 Department of Fetal and Neonatal Development, National Research Institute of Mother and Child Białystok, Poland
  • 3 Department of Endocrinology, Medical Academy Białystok, Poland
Further Information

Publication History

Publication Date:
31 December 2001 (online)

Also available at
    Permissions and Reprints

Pregnancy complicated by poor control of diabetes is associated with a higher risk of embryopathies, spontaneous abortions and perinatal mortality. A number of authors suggest an involvement of reactive oxygen species (ROS) in diabetic pregnancy. Determining lipid peroxidation products (LP), scavenging enzyme activities and the umbilical cord blood’s acid-base balance may contribute to an adequate diagnosis of the neonate at birth. Nevertheless, such measurements seem to have limited value in practical clinical routine. The present study evaluates LP, antioxidant defence and acid-base status related to diabetic pregnancy. Twenty- eight women with type 1 diabetes (PGDM), 19 with gestational diabetes (GDM) and 13 control cases were investigated. An additional control group consisted of 15 healthy patients with negative diabetic history; all women underwent vaginal delivery. Immediately after delivery cord blood samples and placental tissue were collected for malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GSH) determination. Additionally, pH, pCO2, pO2 and base excess were measured in both vessels and compared to identify and exclude double venous samples. MDA levels in both cord blood and placental homogenates were significantly higher in both pregestational and gestational diabetic groups, but SOD activity was significantly diminished. Cord blood GSH was markedly elevated in PGDM and GDM. We have also shown significant differences in acid-base parameters in infants of PGDM group. Statistical analysis was performed using the Mann-Whitney U-test.

These findings indicate an excessive oxidative stress in pregnancy complicated by diabetes mellitus. Evaluating LP products and scavenging enzyme activities may be valuable, sensitive indexes of fetal/neonatal threat in diabetic pregnancy in humans. Since oxidative stress is an important pathway for fetal injury, we believe that obtaining adequate measurements at the time of birth would contribute to clarifying the fetal/neonatal status in a medical and legal context and might be of value in altering therapy in newborn infants.

Key words:

Pregnancy - Diabetes Mellitus - Oxidative Stress - Lipid Peroxidation - Acid-Base Status

References

  • 1 Baker L, Piddington R. Diabetic embryopathy: a selective review of recent trends.  J Diabetes Complications. 1993;  7 204-212
    CrossrefPubMedSearch in Google Scholar
  • 2 Coustan D R, Imarah J. Prophylactic insulin treatment of gestational diabetes reduces the incidence of macrosomia, operative delivery and birth trauma.  Am J Obstet Gynecol. 1984;  150 836-840
    PubMedSearch in Google Scholar
  • 3 Reece E A, Gabrielli S, Abballa M. Prevention of diabetes - associated birth defect.  Semin Perinatol. 1987;  12 292-296
    PubMedSearch in Google Scholar
  • 4 Sadler T W, Hunter E S, Wynn R E, Philips L S. Evidence of multifactorial origin of diabetes induced embryopathies.  Diabetes. 1989;  38 70-74
    PubMedSearch in Google Scholar
  • 5 Kitzmiller J L, Cloherty J P, Younger M D. Diabetic pregnancy and perinatal morbidity.  Am J Obstet Gynecol. 1978;  131 560-580
    PubMedSearch in Google Scholar
  • 6 Saugstad O D. Mechanisms of tissue injury by oxygen radicals: implications for neonatal disease.  Acta Paediatr. 1996;  85 1-4
    PubMedSearch in Google Scholar
  • 7 Almaas R, Sundar T B, Rootwelt T, Øyasæter S, Saugstad O D. Plasma hypoxanthine reacts more abruptly to changes in oxygenation than base deficit and uric acid in newborn piglets.  J Perinat Med. 1997;  25 353-360
    PubMedSearch in Google Scholar
  • 8 Halliwell B. Free Radicals and Antioxidants: A personal view.  Nutrition Reviews. 1994;  52 No 8 253-265
    PubMedSearch in Google Scholar
  • 9 Gutteridge J MC. Lipid peroxidation and antioxidants as biomarkers of tissue damage.  Clin Chem. 1995;  41/12 1819-1828
    PubMedSearch in Google Scholar
  • 10 Kato H, Yoneyama Y, Araki T. Fetal plasma lipid peroxide levels in pregnancies complicated by preeclampsia.  Gynecol Obstet Invest. 1997;  43 158-161
    PubMedSearch in Google Scholar
  • 11 Pryor W A, Godber S S. Noninvasive measures of oxidative stress status in humans.  Free Radic Bio Med. 1991;  10 177-184
    PubMedSearch in Google Scholar
  • 12 Wang W, Pang C CP, Rogers M S, Chang A MZ. Lipid peroxidation in cord blood at birth.  Am J Obstet Gynecol. 1996;  174 62-65
    PubMedSearch in Google Scholar
  • 13 Do¿browski A, Chwiecko M. Oxygen radicals mediate depletion of pancreatic sulfhydryl compounds in rats with cerulein-induced acute pancreatitis.  Digestion. 1990;  47 15-19
    PubMedSearch in Google Scholar
  • 14 Lowry O H, Rosebrough N J, Farr A L, Randal R J. Protein measurement with the Folin phenol reagent.  J Biol Chem. 1951;  193 265-275
    PubMedSearch in Google Scholar
  • 15 Richards D S, Jonson J WC. The practical implications of cord blood acid-base studies.  Clin Obstet Gynecol. 1993;  36 91-104
    CrossrefPubMedSearch in Google Scholar
  • 16 Westgate J, Garibaldi J M, Greene K R. Umbilical cord blood gas analysis at delivery: a time for quality data.  Br J Obstet Gynaecol. 1994;  101 1054-1063
    CrossrefPubMedSearch in Google Scholar
  • 17 Perlman J M, Risser R. Severe Fetal Acidemia: Neonatal Neurologic Features and Short-term Outcome.  Pediatr Neurol. 1993;  9 277-282
    CrossrefPubMedSearch in Google Scholar
  • 18 Marinari U M, Traverso N, Maloberti G, Pronzato M A. Free radicals and fetal pathology.  J Perinat Med. 1994;  22 Suppl. 1 39-41
    PubMedSearch in Google Scholar
  • 19 Eriksson U J, Borg L AH. Protection by free oxygen radical scavenging enzymes against glucose-induced embryonic malformations in vitro.  Diabetes. 1991;  34 325-331
    PubMedSearch in Google Scholar
  • 20 Viana M, Herrera E, Bonet B. Teratogenic effects of diabetes mellitus in the rat. Prevention by vitamin E.  Diabetes. 1996;  39 1041-1046
    PubMedSearch in Google Scholar
  • 21 Speroff L, Reece E A (eds). Diabetes and Development.  In: Seminars in Reproductive Endocrinology.  New York, Stuttgart:; Thieme, 1999 17, no. 2: 117-194
    Search in Google Scholar
  • 22 Weber G F. The Pathophysiology of reactive oxygen intermediates in the central nervous system.  Medical Hypotheses. 1994;  43 223-230
    CrossrefPubMedSearch in Google Scholar
  • 23 Goldman A S, Baker L, Pididington R. Hyperglycemia induced teratogenesis is mediated by functional deficiency in arachidonic acid.  Proc Natl Acad Sci USA. 1985;  82 277-286
    PubMedSearch in Google Scholar
  • 24 Hennig B, Chow C K. Lipid peroxidation and endothelial cell injury: implications in atherosclerosis.  Free Radic Biol Med. 1988;  4 99-106
    CrossrefPubMedSearch in Google Scholar
  • 25 Warso M A, Lands W E. Lipid peroxidation in relation to prostacyclin and thromboxane physiology and pathophysiology.  Br Med Bull. 1983;  39 277-280
    PubMedSearch in Google Scholar
  • 26 Kinalski M, Śledziewski A, Telejko B, Zarzycki W, Kinalska I. Antioxidant therapy and streptozotocin-induced diabetes in pregnant rats.  Acta Diabetol. 1999;  36 113-117
    CrossrefPubMedSearch in Google Scholar
  • 27 Sivan E, Reece E A, Wu Y K, Homko C J, Polansky M, Borenstein M. Dietary vitamin E prophylaxis and diabetic embryopathy: morphologic and biochemical analysis.  Am J Obstet Gynecol. 1996;  175 793-799
    PubMedSearch in Google Scholar
  • 28 Xu L, Badr M Z. Enhanced potential for oxidative stress in hyperinsulinemic rats: imbalance between hepatic peroxisomal hydrogen peroxide production and the composition due to hyperinsulinemia.  Horm Metab Res. 1999;  31: 4 278-282
    PubMedSearch in Google Scholar
  • 29 Rogers M S, Mongelli J M, Tsang K H, Wang C C, Law K P. Lipid peroxidation in cord blood at birth: the effect of labour.  Br J Obstet Gynecol. 1998;  105 739-744
    PubMedSearch in Google Scholar

 M. Kinalski, M.D.

Department of Pathophysiology of Pregnancy
Medical Academy in Białystok

M. Curie-Sklodowska 24 A
15-276 Białystok
Poland


Phone: Phone:+ 48 (85) 4768352

Fax: Fax:+ 48 (85) 4768682

Email: E-mail:Makkinal@amb.ac.bialystok.pl