Fezan ŞAHİN, Esra BASKIN, Erdener BALIKÇI, Ahmet ILGAZLI, Engin ARISOY, A. Sevim GÖKALP, Oktay ÖZKARAKAŞ, Füsun YILDIZ

Sigara içen annelerin yenidoğan kordon kanı eritropoetin seviyeleri

Gebelik sırasında anne adaylarının sigara içmesi fetal hemodinamiyi etkileyerek, kronik hipoksiye neden olmaktadır. Bu çalışmamızda üç gruba ayırdığımız 86 annenin yenidoğanlarının kordon kanında eritropoetin (Epo) düzeylerini tespit ettik. Birinci grupta sigara içen 29 anne ve yenidoğanı, 2. grupta sigara içmeyen 30 anne ve yenidoğanı ve 3. grupta ise pasif içici 27 anne ve yenidoğanı bulunuyordu. Kordon kanı Epo seviyeleri sırasıyla 52.2 ± 5.4 mU/mL, 25.5 ± 5.3 mU/mL ve 26.4 ± 3.7 mU/mL olarak bulundu. Birinci gruptaki Epo düzeylerinde 2. ve 3. grupta karşılaştırıldığında istatistiksel olarak anlamlı artış saptandı (p< 0.05). Yine 1. gruptaki Epo ve hemoglobin düzeyleri arasında anlamlı bir korelasyon gözlendi (p< 0.05). Bu sonuçlar bize gebelik süresince sigara içiminin yenidoğanlarda hipoksi oluşturduğunu ve yükselmiş kordon kanı Epo seviyelerinin bunun bir göstergesi olabileceğini düşündürdü.

Cord blood erythropoietinconcentration in neonates born to smoker mothers

Maternal smoking affects fetal hemodynamics and causes a state of chronic hypoxia. In this study we studied cord blood erythropoietin (Epo) concentrations of 86 neonates who were divided into three groups. In the first group there were 29 smoker mothers and newborns, in the second group 30 nonsmoker mothers and newborns and in the third group 27 passive smoker mothers and newborns. The cord blood Epo concentrations were respectively; 52.2 ± 5.4 mU/mL, 25.5 ± 5.3 mU/mL, and 26.4 ± 3.7 mU/mL. We have found increased concentrations of Epo in the cord blood of neonates whose mothers were smokers when compared with nonsmoker and passive smoker mothers (p< 0.05). In addition there was a significant positive correlation between Epo and hemoglobin concentrations in the first group (p< 0.05). These results suggested that, maternal smoking caused fetal hypoxia and increased Epo concentrations might be a marker of this hypoxia.

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1. Eckart KU, Boutellier U, Kurtz A, et al. Rate of erythropoietin formation in humans in response to acute hypobaric hypoxia. J Appl Physiol 1989; 66: 1785-8.
2. Clemons GK, Fitzsimmons SL, DeManincor D. Immunoreactiue erythropoietin concentrations in fetal and neonatal rats and the effects of hypoxia. Blood 1986; 68:892-9.
3. Voutilainen PEJ, Widness JA, Clemons GK, et al. Amniotic fluid erythropoietin predicts fetal distress in Rh-immunized pregnancies. Am J Obstet Gynecol 1989; 160: 429-34.
4. Widness JA, Teramo KA, Clemons GK, et al. Temporal response of immunoreactive erythropoietin to acute hypoxemia in fetal sheep. Pediatr Res 1986; 20: 15-19.
5. Zanjani ED, Mann LI, Burlington H, et al. Evidence for a physiologic role of erythropoietin in fetal erythropoiesis. Blood 1974; 44: 285-90.
6. Cotes PM, Canning CE, Lind T. Changes in serum immunoreactive erythropoietin during the menstrual cycle and normal pregnancy. Br J Obstet Gynaecol 1983; 90: 304-11.
7. Thomas RM, Canning CE, Cotes PM, et al. Erythropoietin and cord blood haemoglobin İn the regulation of human fetal erythropoiesis. Br J Obstet Gynaecol 1983; 90: 795-800.
8. Teramo RM, Widness JA, Clemons GK, et al. Amniotic fluid erythropoietin correlates with umblical plasma erythropoietin in normal and abnormal pregnancy. Obstet Gynaecol 1987; 69: 710-6.
9. Widness JA, Susa JB, Garcia JF, et al. İncreased erythropoiesis and elevated erythropoietin in infants born to diabetic mothers and in hyperinsulinemic rhesus fetuses. J Clin Invest 1981; 67: 637-42.
10. Widness JA, Teramo KA, Clemons GK, et al. Direct relationship of antepartum glucose control and fetal erythropoietin in human type 1 (insulin-dependent) diabetic pregnancy. Diabetotogia 1990; 33: 378-83.
11. Ruth V, Fyhrquist F, Clemons G, Raivio KO. Cord plasma vasopressin, erythropoietin, and hypoxanthine as indices of asphyxia at birth. Pediatr Res 1988; 24: 490-4.
12. Ruth V, Widness JA, Clemons G, Raivio KO. Postnatal changes in serum immunoreactiue erythropoietin in relation to hypoxia before and after birth. J Pediatr 1990; 116:950-4.
13. Lehlovirta P, Forss M. The acute effect of smoking on intervillous blood flow of the placenta. Br J Obslet Gynaecol 1978:85:729-31.
14.Andersen KV,Hermann N.Placenta flow reduction in pregnant smokers.Acta Obstet Gynaecol Scand 1984;63:707-9
15. Lindblad A, Marsal K, Andersson KE. Effect of nicotine on human fetal blood flow. Obstet Gynaecol 1988; 72: 371-82.
16. Cole PV, Hawkins LH, Roberts D. Smoking during pregnancy and its effects on the fetus.J Obstet Gynaecol Br Common 1972; 79: 782-7.
17. Soothill PW et at. Maternal smoking and fetal carboxyha-emoglobin and blood gas tevels. Br J Obstet Gynecol 1996; 103(1): 78-82.
18. Abel EL. Smoking during pregnancy. A review of effects in growth and development of spring. Human Biol 1980; 52:593.
19. Friesen C, Fax HA. Effects of smoking during pregnancy.Kans Med 1986;87:21.
20. Gnattinggius S, Axelsson O, Exlund G, et at. Smoking, maternal age and fetal growth. Obstet Gynecot 1985; 66: 449.
21. Stewart PJ, Dunkley GC. Smoking and health care patterns among pregnant women. Can Med Assic J 1985; 133: 989.
22. Fried PA. Prenatal exposure to tobacco and marıjuana: Effects during pregnancy, infancy and early childhood. Ctin Obstet Gynecol 1993; 36: 319.
23. Mercelina-Roumans PE et at. Hematological variables in cord blood of neonates of smoking and nonsmoking mothers. J Clin Epidemiol 1996; 49(4): 449-54.
24. Naeye RL Effects of maternal cigarette smoking on the fetus and neonate. İn: naeye RL, ed. Disorders of the placenta, fetus and neonate: diagnosis and clinical significance. St. Louis: Mosby-Year Book 1992: 77-91.