Ayşe Nur AKSOY, İlay GÖZÜKARA, Suna Kabil KUCUR, Gonca BATMAZ, Esra LALOGLU, ELİF BULUT

Spontan Vajinal Doğum Yapan Hastalarda Maternal Serum Beyin Kaynaklı Nörotrofik Faktör ve Malondialdehit Düzeylerindeki Değişimlerin Araştırılması

Amaç: Spontan vajinal doğum eylemindeki kadınlarda maternal serum beyin kaynaklı nörotrofik faktör (BDNF) ve malondialdehit (MDA) seviyelerinde oluşan değişiklikleri ortaya koymak.Gereç ve Yöntem: Bu prospektif çalışma, spontan vaginal doğum eylemindeki term gebeliği olan 62 hastada yapıldı. Doğumun latent fazında (T1), göbek kordonu klemplenmeden hemen önce (T2) ve doğumdan 24 saat sonra (T3) maternal kan örnekleri; doğumda göbek kordonu klemplendikten hemen sonra umblikal arterden kord kanı örneği alındı. Alınan kan örneklerindeki MDA ve BDNF seviyeleri ölçüldü ve uygun istatistik testler kullanılarak sonuçlar karşılaştırıldı. Kord kanı BDNF ile kord kanı MDA seviyeleri ve maternal serum BDNF ile maternal serum MDA seviyeleri arasındaki ilişki araştırıldı.Bulgular: T3 zamanındaki maternal serum BDNF seviyeleri (pg/ml) (3729,92 ± 621,68) T1 (956,75 ± 291,47) ve T2 (985,50 ± 291,91)’ den yüksek bulundu (P<0,0001, her ikisi için). Kord kanı BDNF seviyeleri (834,91 ± 235,73)ise T1, T2 ve T3 zamanlarında alınan maternal serum BDNF seviyelerinden daha düşüktü(P=0,01; P=0,002, P<0,0001; geriye dönük olarak). T3 zamanındaki maternal serum MDA değerleri (µmol/ml) (6,42 ± 1,70), T1 (8,43 ± 2,67) ve T2 (8,80 ± 3,11) zamanlarında değerlerden daha düşük bulundu (P<0,0001; her ikisi için). Kord kanı MDA seviyeleri (9,98 ± 1,70)ise T1, T2 ve T3 zamanlarında alınan maternal serum MDA seviyelerinegöre yüksekti (P=0,001; T2 için ve P<0,0001; T1 ve T3 için). Maternal serum MDA ile BDNF seviyeleri arasında ve kord kanı MDA ile BDNF düzeyleri arasında negatif korelasyon vardı (r= -0,374; P<0,0001; r= -0,310; P=0,014; geriye dönük olarak).Sonuç: Spontan vajinal doğum yapan kadınlarda maternal BDNF ve MDA düzeylerinde değişiklikler meydana gelir. Bu değişiklikler, doğum eylemi sırasında artan maternal oksidatif stres ile ilişkili olabilir.

Anahtar Kelimeler:

Obstetrik doğum, kordon kanı, beyin kaynaklı nörotrofik faktör, malondialdehit.

Investigating The Changes In Maternal Serum Brain-Derived Neurotrophic Factor Levels In Patients Undergoing Spontaneous Vaginal Delivery

Objective: To reveal the changes in maternal serum brain-derived neurotrophic factor (BDNF) and malondialdehyde (MDA) levels in women undergoing spontaneous vaginal delivery.Material and Method: This prospective study was done in sixty-two patients with term pregnancy undergoing spontaneous vaginal delivery. Maternal blood samples in the latent phase of labor (T1), immediately before clamping the umbilical cord (T2) and 24 hours after birth (T3); and umbilical artery cord blood sample immediately after umbilical cord clamping at delivery were obtained. MDA and BDNF levels in collected blood samples were measured and results were compared using appropriate statistical tests. The relationship between cord blood levels of BDNF with cord blood MDA and maternal serum levels of BDNF with maternal serum MDA was investigated.Results: Maternal serum BDNF levels (pg/ml) were significantly higher in the blood sample collected at the T3 time point (3729.92 ± 621.68) compared to blood samples collected at T1 (956.75 ± 291.47) and T2 (985.50 ±291.91)time points (P<0.0001, for both). Cord blood BDNF levels (834.91 ± 235.73)were significantly lower compared to maternal blood samples collected at T1, T2 and T3 time points (P=0.01, P=0.002, P<0.0001; retrospectively). Maternal serum MDA levels (µmol/ml) at T3 time point (6.42 ± 1.70) were found to be lower compared with those of collected blood samples at T1 (8.43 ± 2.67) and T2 (8.80 ± 3.11) time points (P<0.0001, for both). Also, cord blood MDA levels (9.98 ± 1.70) were higher compared to maternal serum MDA levels collected at T1, T2 and T3 time points (P=0.001, for T2 and P<0.0001, for T1 and T3 time points). A negative association was found between both maternal and cord blood BDNF levels with maternal and cord blood MDA levels, respectively (r= -0.374, P<0.0001; r= -0.310, P=0.014; respectively).Conclusion: Changes in maternal BDNF and MDA levels occur in women undergoing spontaneous vaginal delivery. These changes may be associated with increased maternal oxidative stress during labor.

Keywords:

Obstetric delivery, cord blood, brain-derived neurotrophic factor, malondialdehyde,

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