George D. Vlachos

Maternal-neonatal 8-hydroxy-deoxyguanosine serum concentrations as an index of DNA oxidation in association with the mode of labour and delivery

Aim. To investigate the effect of the mode of labour and delivery on the total antioxidant status (TAS), and the biomarker of DNA oxidation, 8‐hydroxy‐deoxyguanosine (8‐OHdG) serum levels, in mothers and their newborns. Subjects and methods. Some 106 women with normal pregnancy and normal blood biochemical parameters were divided into 4 groups: Group A (n = 28) with normal labour and vaginal delivery (VG), Group B (n = 25) with scheduled cesarean section (CS), Group C (n = 26) with ‘emergency’ CS, and Group D (n = 27) with prolonged labour + VG. Blood was obtained from the mothers at the beginning of labour, and immediately after delivery (pre‐ and post‐delivery), as well as from the umbilical cord (CB). TAS, 8‐OHdG and creatine kinase (CK) were measured in the sera with appropriate methodology. Results. TAS levels were almost similar in all the groups pre‐delivery, and in CB irrespective of the mode of labour and delivery, and remarkably decreased in Groups C and D post‐delivery. 8‐OHdG levels in Group C (0.94±0.08 ng/ml) and Group D (0.98±0.08 ng/ml) were significantly higher than those in Group A (0.26±0.01 ng/ml, p<0.001) and Group B (0.28±0.07 ng/ml, p<0.001) post‐delivery. 8‐OHdG levels were low in CB, independent of the mode of labour. CK positively correlated with 8‐OHdG (r = 0.48, p<0.001), the latter negatively correlated with TAS (r = − 0.53, p<0.01). Conclusions. The lowest TAS and the highest 8‐OHdG levels were found in Groups C and D post‐delivery, probably due to the long‐term participation of the mothers’ skeletal and uterus muscles, whereas 8‐OHdG levels were low in CB irrespective of the mode of delivery, possibly as a consequence of the antioxidant action of the placenta and/or the low lipid levels in the serum of the umbilical cord.

Evaluation of glucose-6-phosphate dehydrogenase activity in two different ethnic groups using a kit employing the haemoglobin normalization procedure.

AIM Correct evaluation of Glucose-6-Phosphate Dehydrogenase (G-6-PD) activity of two ethnic groups using a fully quantitative kit with a simultaneous Hemoglobin Normalization (Hb Normalization) procedure. DESIGN AND METHODS Two groups of mothers and their healthy full term newborns of Greek (n = 1.166) and Albanian (n = 818) origin were tested for their G-6-PD activity employing a direct normalization protocol. RESULTS Greek mothers and newborns showed a higher prevalence for G-6-PD deficiency as compared to those of Albanian origin. Males of G-6-PD deficient mothers confirmed the efficacy of the method. CONCLUSION A fully quantitative G-6-PD kit employing Hb Normalization is essential for the correct classification of G-6-PD activity, both in male and female subjects.

p16 INK4A Is a Strong Biomarker for Cervical Intraepithelial Neoplasia and Invasive Cervical Carcinoma: A Reappraisal

To assess the role of p16 INK4A, bcl-2, and p53 in cervical cancer screening, we conducted a retrospective trial of prospectively collected data. Sixty two women with abnormal Pap smears were subjected to colposcopy and biopsies from any abnormal lesion. Human papillomavirus (HPV)-DNA typing, histology, and immunochemistry for p16INK4A, bcl-2, and p53 were performed for these women. Histologic diagnosis was that of low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion (HSIL), or cancer in all cases. Human papillomavirus strains were identified in 56 patients (90.3%). All HSIL and invasive cancer cases were HPV positive. p16INK4A immunostaining yielded 100% sensitivity, 76% specificity, 61% positive predictive value, and 100% negative predictive value in cancer patients. The corresponding performance indicators for HSIL patients were 75%, 62%, 32%, and 91%. bcl-2 and p53 expression did not correlate with worsening grades of cervical disease. We conclude that p16INK4A seems to be a sensitive biomarker of high grade cervical intraepithelial neoplasia and cancer.

The effect of the mode of delivery on maternal-neonatal interleukin-6, biogenic amine and their precursor amino acid concentrations.

Abstract Background: Biogenic amine, adrenaline, noradrenaline, dopamine and 5-hydroxy-tryptamine (5-HT) levels are related to interleukin-6 (IL-6) plasma concentrations and endurance exercise. The aim of our study was to investigate the effect of the mode of delivery on maternal-neonatal IL-6, biogenic amine and their precursor amino acid levels. Methods: Some women with normal pregnancy (n=56) were divided into two groups: group A (n=26) with normal labor and vaginal delivery, and group B (n=30) with scheduled cesarean section. Blood was obtained from the mothers at the beginning of labor and immediately after delivery (pre- vs. post-delivery), as well as from the umbilical cord (CB). Total antioxidant status (TAS) and IL-6 levels were measured with commercial kits, the precursor amino acids, tyrosine and tryptophan with tandem mass spectrometry and the biogenic amine blood levels with HPLC methods, respectively. Results: TAS, IL-6, biogenic amine and their precursor amino acid blood levels were similar in the two groups of mothers pre-delivery. TAS levels were reduced, whereas the amino acids, the catecholamine, 5-HT and IL-6 levels were increased post-delivery and in the CB of group A and unaltered in group B at the same time of the study. Conclusions: During a vaginal delivery process, the low TAS, the increased levels of the studied amino acids, the catecholamines, 5-HT and IL-6 may be due to the activation of the neuroendocrine system and the participation of skeletal and uterine muscles. The mode of delivery may be taken into account when IL-6 plasma levels are evaluated as an anti-inflammatory index perinatally. Clin Chem Lab Med 2008;46:1624–30.

The effect of the mode of delivery on the maternal-neonatal carnitine blood levels and antioxidant status

Abstract Background: Carnitine blood levels are closely related to β-oxidation and implicated with strenuous muscle contractions. Normal delivery process is characterized by the participation of the uterus and most skeletal muscles. Methods: Women with normal pregnancy (n=56) were divided into two groups. Group A (n=26) with normal labor and vaginal delivery and group B (n=30) with scheduled cesarean section. Blood was obtained from the mothers at the beginning of labor and immediately after delivery (pre- vs. post-delivery), as well as from the cord blood (CB). Total antioxidant status (TAS) was measured with a commercial kit and carnitine was measured in blood spots on Guthrie cards with tandem-mass spectrometry. Results: TAS and carnitine levels were similar in all the groups pre-delivery. In contrast, TAS and carnitine levels were significantly lower in group A than in group B post-delivery. Remarkably lower TAS and carnitine levels were measured in the CB of neonates of group A as compared to the CB of neonates of group B. Conclusions: The lower TAS and carnitine levels measured in group A as compared to group B post-delivery may be due to uterus and skeletal muscle contraction during a normal labor process. Infants born with scheduled cesarean section are benefited with high carnitine levels to face oxidation perinatally. Clin Chem Lab Med 2008;46:680–6.

The effect of the mode of delivery on the maternal-neonatal erythrocyte membrane acetylcholinesterase activity.

UNLABELLED Free radical production and high catecholamine levels are implicated with the modulation of acetylcholinesterase (AChE) activity. OBJECTIVE To investigate the effect of the mode of delivery on maternal-neonatal erythrocyte membrane AChE activity. SUBJECTS AND METHODS Some women with normal pregnancy (N = 30) were divided into two groups: group A (N = 16) with normal labour and vaginal delivery and group B (N = 14) with scheduled Cesarean section, twenty non-pregnant women were the controls. Blood was obtained from controls and from mothers pre- vs post-delivery as well as from the umbilical cord (CB). Total antioxidant status (TAS), membrane AChE activities and catecholamine blood levels were measured with a commercial kit, spectrophotometrically and HPLC methods, respectively. RESULTS TAS and catecholamine levels as well as membrane AChE activities were similar in the two groups of mothers pre-delivery and in controls. TAS levels were reduced whereas AChE activities and catecholamine levels were increased post-delivery in mothers of group A and unaltered in group B at the same times of study. AChE activity was similarly lower in the CB of neonates than those of their mothers pre-delivery. CONCLUSIONS During a normal delivery process, the low TAS, the increased levels of catecholamines and the increased AChE activity, post-delivery, may be due to the increased stress due to the participation of uterus and skeletal muscles as during endurance exercise. The low AChE activity in newborns may be related to perinatal immaturity.

The effect of nutritional habits on maternal- neonatal lipid and lipoprotein serum levels in three different ethnic groups

Aim: To investigate the effect of nutritional habits on lipid profiles in mothers of three different ethnic groups and in their newborns. Subjects and Methods: Lipids and lipoproteins were determined in 7-day dietetic diaries of 9,134 mothers (Greeks n = 3,118, Albanians n = 3,050, Muslim Asians n = 2,966), in their sera and in the cord blood of their newborns with routine methods. Results: Monounsaturated fat intake (35 ± 12 g/day) was similar among the groups. Total fat, saturated fat and cholesterol intakes were significantly lower in Asians than those in Albanians and Greeks. Significantly lower lipid and lipoprotein concentrations (cholesterol 5.09 ± 0.85 mmol/l, triglyceride, TG, 2.38 ± 0.58 mmol/l, low-density lipoprotein cholesterol, LDL-C, 2.90 ± 0.78 mmol/l, very-low-density lipoprotein cholesterol, VLDL-C, 0.32 ± 0.11 mmol/l) were measured in the Muslim Asian mothers and in their newborns (cholesterol 1.06 ± 0.26 mmol/l, TG 0.52 ± 0.16 mmol/l, LDL-C 0.49 ± 0.10 mmol/l and VLDL-C 0.10 ± 0.02 mmol/l; p < 0.001). Higher levels of the mentioned biochemical parameters were found in Greek mothers versus their newborns (cholesterol 5.20 ± 0.98 mmol/l, TG 2.37 ± 0.62 mmol/l, LDL-C 3.40 ± 0.85 mmol/l and VLDL-C 0.48 ± 0.13 mmol/l vs. cholesterol 1.55 ± 0.31 mmol/l, TG 0.56 ± 0.20 mmol/l, LDL-C 0.65 ± 0.15 mmol/l and VLDL-C 0.12 ± 0.01 mmol/l; p < 0.001) and Albanian mothers versus their newborns (cholesterol 7.1 ± 0.78 mmol/l, TG 2.55 ± 0.60 mmol/l, LDL-C 4.1 ± 0.88 mmol/l and VLDL-C 0.52 ± 0.13 mmol/l vs. cholesterol 1.6 ± 0.40 mmol/l, TG 0.59 ± 0.15 mmol/l, LDL-C 0.70 ± 0.21 mmol/l and VLDL-C 0.12 ± 0.01 mmol/l; p < 0.001). The highest HDL-C levels were observed in the Asian mothers (1.60 ± 0.31 mmol/l vs. 1.4 ± 0.39 mmol/l in Greeks and 1.31 ± 0.39 mmol/l in Albanians; p < 0.001). Conclusion: The normal lipid profile in Greeks, the high one in Albanians and the low profile in Muslim Asians may be due to their nutritional habits and their socioeconomic status affecting those of their newborns.

Maternal-neonatal magnesium and zinc serum concentrations after vaginal delivery

Abstract Background/aims. To investigate the effect of the mode of delivery on maternal-neonatal Mg and Zn levels. Material and methods. Two groups of pregnant women participated in the study: Group A (n = 16) with normal labor and vaginal delivery and group B (n = 14) with scheduled cesarean section (CS). Blood was obtained at the beginning of the labor, immediately after delivery and from the umbilical cord (CB). Serum Mg and Zn were measured with atomic absorption spectroscopy and total antioxidant status (TAS) levels with a chemical autoanalyser. Results. Mg, Zn and TAS levels were similar pre-delivery in both groups. TAS levels, Mg (0.81 ± 0.09 vs 0.69 ± 0.03 mmol/L, p < 0.001) and Zn levels (9.34 ± 0.37 vs 5.74 ± 0.24 μmol/L, p < 0.001) were significantly decreased after vaginal delivery. These biochemical parameters were measured practically unaltered at the same times of study in group B. The mineral levels did not differ in the CB of both groups. Conclusions. The decreased maternal Mg, Zn and TAS levels post vaginal delivery may be due to the participation of skeletal and uterus muscles and the similar levels of the minerals in the CB of neonates to the placental protection.

Modulated human maternal and premature neonatal erythrocyte membrane enzyme activities in relation to the mode of delivery: in vitro restoration with L-carnitine.

Kleopatra H. Schulpis, George D. Vlachos, Aris Antsaklis, Charis Liapi, Vasileios Stolakis, Apostolos Zarros and Stylianos Tsakiris* 1 Institute of Child Health, ‘‘Aghia Sophia’’ Children’s Hospital, Athens, Greece 2 1st Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece 3 Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Athens, Greece 4 Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece

Maternal-neonatal amino acid blood levels in relation to the mode of delivery.

Objective. To investigate the effect of the mode of delivery on maternal–neonatal amino acid levels as high blood levels of some amino acids are implicated with endurance exercise. Design. Comparative study. Sample. Thirty women in normal pregnancy divided into two groups: Group A (n = 15) with normal labor and vaginal delivery and group B (n = 15) with scheduled cesarean section. Material and methods. Blood was obtained from the mothers pre‐ versus post‐delivery as well as from the umbilical cord. Routine laboratory tests (liver enzymes, muscle enzyme, etc.) and the amino acid blood levels were measured with a clinical chemistry analyzer and tandem mass spectrometry methods, respectively. Results. Routine laboratory tests and the amino acid blood levels were similar in the two groups of mothers pre‐delivery. Total antioxidant status levels were reduced, whereas the branched‐chain amino acids (BCAAs) and alanine levels were remarkably elevated in the sera of group A post – delivery, whereas they remained unaltered in group B at the same time of study. The mentioned BCAAs and alanine levels were higher in the umbilical cord blood of group A than those in group B. The rest of the amino acids were similar. Conclusions. The increased BCAAs and alanine blood levels in mothers of group A may be related to uterine and skeletal muscle contractions during the vaginal delivery process and the high levels in the umbilical cord blood of their neonates may mirror those of the mothers. The elevation of BCAAs both in mothers of group A and their neonates may exclude or minimize tyrosine and tryptophane levels from entry in the brain resulting in decreased biogenic amine and increased prolactin production in the central nervous system of these mothers and their infants.