Amniotic Fluid Oxidative and Nitrosative Stress Biomarkers Correlate with Fetal Chronic Hypoxia in Diabetic Pregnancies

Escobar, Javier; Teramo, Kari; Stefanović, Vedran; Andersson, Sture; Asensi, Miguel; Arduini, Alessandro; Cubells, Elena; Sastre, Juan; Vento, Máximo

doi:10.1159/000345194

Cited by 63 publications

(49 citation statements)

References 64 publications

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“…HOCl is too short-lived and cannot, therefore, be measured in biological materials. However, the effects of HOCl on other molecules such as tyrosine can be measured by mass spectrometry in biofluids in the form of 3-chloro-tyrosine [44]. Another relevant candidate reflecting the prooxidant action of HOCl is glutathione sulfonamide (GSA), a stable oxidation product of reduced glutathione (GSH).…”

Section: Diagnostic Biomarkersmentioning

confidence: 99%

Ventilator-Associated Pneumonia in Neonatal Patients: An Update

et al. 2013

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Ventilator-associated pneumonia (VAP) is a serious complication related to mechanical ventilation in the neonatal period. However, lack of a specific definition and difficulties obtaining noncontaminated samples of the lower respiratory airway render microbiological diagnosis and etiological treatment extremely difficult. Thus far, only few studies have approached VAP using accepted Centers for Disease Control and Prevention criteria and reliable sampling techniques. In recent years, however, the blind-protected bronchoalveolar lavage technique with protected specimen brush and the development of validated biomarkers have attempted to overcome the diagnostic difficulties and assess the response to therapy. This updated review on neonatal VAP aims to stimulate neonatologists' interest in this subtle but serious complication of mechanical ventilation.

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Section: Diagnostic Biomarkersmentioning

confidence: 99%

Ventilator-Associated Pneumonia in Neonatal Patients: An Update

et al. 2013

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“…Kainer et al suggest there is an individual threshold at which maternal blood glucose causes hyperinsulinism [8]. The relation of fetal weight and intrauterine chronic hypoxia may well be U-shaped and oxidative stress markers are released into the amniotic fluid [3,9]. The relation between erythropoietin and PI is found in growth restricted fetuses of non-diabetic women [10].…”

Section: Discussionmentioning

confidence: 99%

Umbilical Pulsatility Index is Associated with Fetalacidemia in Type 1 Diabetic Pregnancies

Rasmussen¹

2013

Gynecol Obstet

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This study was designed to test umbilical indices and establish a reference in pregnancies complicated by type 1 diabetes mellitus, and to correlate the pulsatility index to other clinical parameters.We included consecutively 129 type 1 diabetic pregnant women during a five year period. During their pregnancy HbA1c, electrolytes, uric acid, diurnal blood pressure was measured and 24-h urine collected for measurement of albumin excretion rate. Umbilical blood flow measurements were done routinely from week 32 and started before week 32 on indication. Resistance and pulsatility indices and systolic-diastolic ratio were measured.The weekly repeated measurements from gestational 32 to 34 had the lowest levels of pulsatility index in the normoalbuminuria group and highest in the micro-and macroalbuminuria group combined (p = 0.01).We found an association of pulsatility index and umbilical pH (p<0.006). Even when adjusted for birth weight ratio, blood pressure, albumin excretion rate and HbA1c the association of pulsatility index and umbilical pH persisted (r = -0.30, p = 0.016). Glycemia expressed as HbA1c was associated with pulsatility index at nearly all measurements from week 31 to 35 and associated with albumin excretion rate.We were not able to predict adverse feto-maternal outcome in our pregnancies using umbilical indices. The correlation of pulsatility index and HbA1c underlines the importance of glycemic status during pregnancy. Albumin excretion rate affects the level of the umbilical pulsatility index.

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“…EPO levels in the amniotic fluid correlate highly with biomarkers of oxidative stress (meta-tyrosine/phenylalanine ratio), damage to DNA (8-oxodG/2dG ratio) and nitrosative stress (nitro-tyrosine). Moreover, newly born infants with high levels of EPO in the amniotic fluid have increased perinatal morbidity [22]. …”

Section: Hypoxia In Utero Is Relativementioning

confidence: 99%

Oxygen Supplementation in the Neonatal Period: Changing the Paradigm

Vento

2014

Neonatology

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Oxygen is one of the most widely used drugs in the neonatal period. A lack of knowledge of oxygen metabolism and toxicity has prompted guidelines to fluctuate from liberal use to treat respiratory distress to restriction to avoid retinopathy of prematurity. In recent years, studies performed in the immediate postnatal period have revealed that newly born infants achieve a stable saturation only several minutes after birth. Moreover, the time needed to reach a saturation plateau is inversely proportional to a newborn's gestational age. As a consequence, guidelines have changed and recommend an individualized supplementation in the first minutes after birth with the inspiratory fraction of oxygen titrated against preductal pulse oximetry. However, randomized controlled trials have concluded that, after postnatal stabilization, keeping preterm babies within a low-saturation target range (85-89%) may lead to increased mortality while keeping them in a higher saturation range (91-95%) increases the risk of retinopathy of prematurity. The present state of the art in the management of oxygen supplementation recommends that caregivers in the delivery room allow preductal oxygen saturation to spontaneously increase in the first minutes of life; however, if supplemented, it should be titrated according to pulse oximeter readings and kept within the safe margins of the nomogram. Thereafter, if oxygen is still needed, it should be kept within stringent security margins (90-95%) to avoid deleterious consequences. Importantly, in babies with chronic lung disease, oxygen should be supplemented to allow the patient to grow and develop.

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Amniotic Fluid Oxidative and Nitrosative Stress Biomarkers Correlate with Fetal Chronic Hypoxia in Diabetic Pregnancies

Cited by 63 publications

References 64 publications

Ventilator-Associated Pneumonia in Neonatal Patients: An Update

Ventilator-Associated Pneumonia in Neonatal Patients: An Update

Umbilical Pulsatility Index is Associated with Fetalacidemia in Type 1 Diabetic Pregnancies

Oxygen Supplementation in the Neonatal Period: Changing the Paradigm

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