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Farisoğullari N, Tanaçan A, Sakcak B, Denizli R, Özdemir EÜ, Elmas B, Canpolat FE, Neşelioğlu S, Erel Ö, Şahin D. The association of umbilical cord blood oxidative stress with maternal iron deficiency anemia: A tertiary center experience. Int J Gynaecol Obstet 2024. [PMID: 39016277 DOI: 10.1002/ijgo.15808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 04/01/2024] [Accepted: 07/08/2024] [Indexed: 07/18/2024]
Abstract
OBJECTIVE To compare the levels of oxidative stress markers in the umbilical cord blood between pregnant women diagnosed with iron deficiency anemia (IDA) and low-risk controls. METHODS The sample consisted of 131 patients, including 55 pregnant women with IDA and 76 controls with similar demographic characteristics. Participants were selected from patients delivered at ≥37 weeks. We compared the two groups in terms of the native thiol, total thiol, disulfide, and ischemia-modified albumin (IMA) levels measured in pregnant women's umbilical cord venous blood. RESULTS The native thiol and total thiol values were statistically significantly lower in the anemia group, and the disulfide and IMA values were statistically significantly higher in the IDA group (P < 0.001). Perinatal outcomes were similar between the groups. CONCLUSION In the present study, pregnant women with IDA had lower native and total thiol values and higher disulfide and IMA values in umbilical cord blood. Iron deficiency anemia in pregnancy may be a potential cause of increased oxidative stress.
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Affiliation(s)
- Nihat Farisoğullari
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanaçan
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Bedri Sakcak
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ramazan Denizli
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Eda Üreyen Özdemir
- Department of Gynecology and Obstetrics, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Burak Elmas
- Department of Gynecology and Obstetrics, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Fuat Emre Canpolat
- Department of Neonatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Salim Neşelioğlu
- Department of Biochemistry, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Özcan Erel
- Department of Biochemistry, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Dilek Şahin
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
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Blok EL, Burger RJ, Bergeijk JEV, Bourgonje AR, Goor HV, Ganzevoort W, Gordijn SJ. Oxidative stress biomarkers for fetal growth restriction in umbilical cord blood: A scoping review. Placenta 2024; 154:88-109. [PMID: 38943922 DOI: 10.1016/j.placenta.2024.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 07/01/2024]
Abstract
Fetal growth restriction and underlying placental insufficiency are associated with increased oxidative stress. Current diagnostics fail to identify all growth restricted fetuses and newborns, due to focus on small size. This scoping review aims to summarize the available evidence on usefulness of cord blood oxidative stress biomarkers for identification of growth restricted newborns in need of monitoring and support because of associated health risks. MEDLINE and EMBASE were searched from inception to May 2024. Studies were included if oxidative stress biomarkers were measured in cord blood collected immediately after delivery in newborns suspected to be growth restricted. Biomarkers were categorized based on the origin and/or biological function and their interrelationships. Oxidative stress was determined for each individual biomarker and category. Literature search identified 78 studies on 39 different biomarkers, with a total of 2707 newborns with suspected growth restriction, and 4568 controls. Total oxidant/antioxidant status, catalase, glutathione, ischemia-modified albumin, and nucleated red blood cells were most consistently associated with suspected growth restriction. Reactive oxygen species/reactive nitrogen species, factors in their production, antioxidant enzymes, non-enzymatic antioxidants, and products of oxidative stress were not consistently associated. This review collates the evidence of associations between cord blood oxidative stress biomarkers and growth restriction. Total oxidant/antioxidant status, catalase, glutathione, ischemia-modified albumin, and nucleated red blood cells could potentially be candidates for developing a cord blood diagnostic tool for future clinical use.
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Affiliation(s)
- Evelien L Blok
- Amsterdam UMC Location University of Amsterdam, Department of Obstetrics and Gynaecology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands.
| | - Renée J Burger
- Amsterdam UMC Location University of Amsterdam, Department of Obstetrics and Gynaecology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands.
| | - Jenny E Van Bergeijk
- University Medical Center Groningen, University of Groningen, Department of Obstetrics and Gynaecology, Hanzeplein 1, Groningen, the Netherlands.
| | - Arno R Bourgonje
- University Medical Center Groningen, University of Groningen, Department of Gastroenterology and Hepatology, Hanzeplein 1, Groningen, the Netherlands.
| | - Harry Van Goor
- University Medical Center Groningen, University of Groningen, Department of Pathology and Medical Biology, Hanzeplein 1, Groningen, the Netherlands.
| | - Wessel Ganzevoort
- Amsterdam UMC Location University of Amsterdam, Department of Obstetrics and Gynaecology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands.
| | - Sanne J Gordijn
- University Medical Center Groningen, University of Groningen, Department of Obstetrics and Gynaecology, Hanzeplein 1, Groningen, the Netherlands.
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Erol SA, Tanacan A, Altinboga O, Ozturk FH, Ozgu BS, Tasci Y, Neselioglu S, Erel O, Sahin D. Evaluation of Fetal Serum Thiol/Disulfide Homeostasis and Ischemia-Modified Albumin Levels in Fetal Distress. Fetal Pediatr Pathol 2022; 41:426-435. [PMID: 33063566 DOI: 10.1080/15513815.2020.1831662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Aim: We investigated the association of fetal serum thiol/disulfide homeostasis and ischemia-modified albumin (IMA) levels with fetal distress (FD). Methods: Umbilical cord blood for native thiol, total thiol, disulfide, albumin, and IMA analysis was obtained from 44 pregnant women over 34 weeks gestation undergoing cesarean section due to non-acute FD, and from 61 healthy pregnant women who underwent elective cesarean section Results: Native thiol and total thiol levels were significantly lower in the FD group (p = 0.02 and p = 0.014, respectively). Although disulfide/native thiol and disulfide/total thiol ratios were higher in the FD group, the difference was statistically insignificant (p = 0.805). The IMA levels were significantly higher in the FD group (p = 0.013). Conclusion: The thiol-disulfide homeostasis shifts toward the oxidant direction during the FD pathogenesis and the increased IMA levels may be the best indicator of an underlying non-acute ischemic condition.
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Affiliation(s)
- Seyit Ahmet Erol
- Department of Perinatology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanacan
- Department of Perinatology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Orhan Altinboga
- Department of Perinatology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Filiz Halici Ozturk
- Department of Perinatology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Burcin Salman Ozgu
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Yasemin Tasci
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Salim Neselioglu
- Department of Clinical Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Ozcan Erel
- Department of Clinical Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Dilek Sahin
- Department of Perinatology, Ministry of Health Ankara City Hospital, Ankara, Turkey
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Melekoğlu R, Yaşar Ş, Zeyveli Çelik N, Özdemir H. Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross-sectional, case-control study. Turk J Obstet Gynecol 2022; 19:7-20. [PMID: 35343215 PMCID: PMC8966325 DOI: 10.4274/tjod.galenos.2022.36744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: In this study, we examined the serum hematologic and lipid parameters of pregnant women with preeclampsia and an age- and gestational-age matched normotensive control group. We also compared the ratios of hemato-lipid parameters defined as systemic inflammatory markers and determined the predictive value of these values in preeclampsia. Materials and Methods: All patients diagnosed with late-onset preeclampsia or severe preeclampsia between 34 and 40 weeks of gestation at Inonu University Faculty of Medicine between March 2019 and October 2020 were included. Results: A total of 253 pregnant women were included in the study period. When the study groups were compared in terms of hematological and blood lipid profile; while serum lymphocyte, triglyceride, and total cholesterol levels were significantly higher in the preeclampsia group than in the control group (p<0.001, p<0.001, p=0.013, respectively); high-density lipoprotein (HDL)-cholesterol levels were found to be significantly lower (p=0.017). The cut-off value for the monocyte/HDL ratio in predicting severe preeclampsia was 16.65 with 59.0% sensitivity and 85.4% specificity [the area under the receiver operating characteristic 0.756, 95% confidence interval (CI) 0.681-0.821, p<0.001]. Multivariate analysis showed that the monocyte/HDL ratio was independently associated with both preeclampsia and severe preeclampsia [odds ratio (OR): 1.094; 95% CI 1.009-1.185 and OR: 1.731; 95% CI 1.218-2.459, respectively]. Conclusion: This study demonstrated that serum triglyceride and total cholesterol levels were significantly higher and serum HDL-cholesterol levels were significantly lower in pregnant women with late-onset preeclampsia compared to normotensive pregnant women. Additionally, this study revealed that the measurement of monocyte/HDL ratio in the pregnant population could be a useful clinical tool for predicting preeclampsia.
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Sert UY, Ozel S, Neselioglu S, Erel O, Engin Ustun Y. Water Immersion During the Labour and Effects on Oxidative Stress. Fetal Pediatr Pathol 2020; 39:185-193. [PMID: 31436109 DOI: 10.1080/15513815.2019.1651801] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Objective: The study aims to investigate maternal serum thiol/disulfide homeostasis and ischemia-modified albumin (IMA) levels of women who were submerged during labor. Material and methods: Sixty-four pregnant women were enrolled in this study. Thirty-four women were submerged during the first stage of labor and 30 women were not. Native thiol, total thiol, disulfide, albumin, IMA, disulfide/native thiol, disulfide/total thiol and native thiol/total thiol concentrations were measured and demographic data were obtained. Results: Cord blood pH, serum disulfide levels and (disulfide/total thiol) × 100 levels were significantly lower in the water immersion group (P < 0.01, P = 0.01 and P < 0.01, respectively). Native thiol, total thiol, albumin and IMA levels were higher in the water immersion group P < 0.01, P < 0.01, P = 0.001 and P < 0.01, respectively). Conclusion: Water immersion during the first stage of labor was found to be associated with deterioration of thiol-disulfide homeostasis with respect to antioxidant status while IMA levels were higher, suggesting an ischemic condition.
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Affiliation(s)
- Umit Yasemin Sert
- Zekai Tahir Burak Women's Health Training and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Sule Ozel
- Zekai Tahir Burak Women's Health Training and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Salim Neselioglu
- Faculty of Medicine, Yildirim Beyazit University, Department of Clinical Biochemistry, Ankara, Turkey
| | - Ozcan Erel
- Faculty of Medicine, Yildirim Beyazit University, Department of Clinical Biochemistry, Ankara, Turkey
| | - Yaprak Engin Ustun
- Zekai Tahir Burak Women's Health Training and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
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Can Ibanoglu M, Yasar Sanhal C, Ozgu-Erdinc S, Kara O, Yucel A, Uygur D. Maternal plasma fetuin-A levels in fetal growth restriction: A case-control study. Int J Reprod Biomed 2019; 17:487-492. [PMID: 31508574 PMCID: PMC6718885 DOI: 10.18502/ijrm.v17i7.4860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 12/24/2018] [Accepted: 04/30/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Higher Fetuin-A (FA) concentrations were found to be associated with obesity and there is an interest to the relation between maternal FA and pregnancy outcomes. OBJECTIVE In this study, our aim was to evaluate the association of maternal plasma levels of FA with fetal growth restriction (FGR). MATERIALS AND METHODS 41 pregnant women with FGR and 40 controls were recruited in this case-control study between July and November 2015. At the diagnosis of FGR, venous blood samples (10 cc) were obtained for FA analysis. RESULTS Maternal plasma FA levels were significantly higher in fetal growth-restricted pregnant women compared with controls (19.3 ± 3.0 ng/ml vs 25.9 ± 6.8 ng/ml, p = 0.001). Area under receiver operating characteristic curve analysis of FA in FGR was 0.815 (95% confidence interval (CI): 0.718-0.912, p < 0.001). The maternal FA levels with values more than 22.5 ng/ml had a sensitivity of about 73.17% (95% CI: 56.79-85.25) and a specificity of about 82.5% (95% CI: 66.64-92.11) with positive and negative predictive values of about 81.08% (95% CI: 64.29-91.45) and 75% (95% CI: 59.35-86.30), respectively. Therefore, the diagnostic accuracy was obtained about 77.78%. CONCLUSION The results of this study show higher maternal plasma levels of FA in FGR. Further studies are needed in order to demonstrate the long-term effects of FA in pregnancies complicated with FGR and early prediction of FGR.
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Affiliation(s)
- Mujde Can Ibanoglu
- University of Health Sciences, Dr. Zekai Tahir Burak Women's Health Care, Education and Research Hospital, Ankara, Turkey
| | - Cem Yasar Sanhal
- University of Health Sciences, Dr. Zekai Tahir Burak Women's Health Care, Education and Research Hospital, Ankara, Turkey
| | - Seval Ozgu-Erdinc
- University of Health Sciences, Dr. Zekai Tahir Burak Women's Health Care, Education and Research Hospital, Ankara, Turkey
| | - Ozgur Kara
- University of Health Sciences, Dr. Zekai Tahir Burak Women's Health Care, Education and Research Hospital, Ankara, Turkey
| | - Aykan Yucel
- University of Health Sciences, Dr. Zekai Tahir Burak Women's Health Care, Education and Research Hospital, Ankara, Turkey
| | - Dilek Uygur
- University of Health Sciences, Dr. Zekai Tahir Burak Women's Health Care, Education and Research Hospital, Ankara, Turkey
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Andıç E, Karaman E, Kolusarı A, Çokluk E. Association of cord blood ischemia-modified albumin level with abnormal foetal Doppler parameters in intrauterine growth-restricted foetuses. J Matern Fetal Neonatal Med 2019; 34:1-6. [PMID: 30691329 DOI: 10.1080/14767058.2019.1569623] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: To investigate cord blood ischemia-modified albumin (IMA) levels in pregnancies with intrauterine growth restriction (IUGR) and to determine its association with abnormal fetal Doppler findings.Methods: Umbilical cord IMA levels were assessed in 34 pregnant women with IUGR and 32 pregnancies with normal fetal development. Associations of IMA with abnormal umbilical artery Doppler findings, preeclampsia, and oligohydramnios were investigated. IMA was measured using a colorimetric test based on a decrease in cobalt binding.Results: No significant between group differences in maternal age, body mass index, gravida, and parity were identified. The mean gestational age at delivery was earlier in the IUGR group than in the control group (35.7 ± 3.2 versus 38.4 ± 1.2, respectively). The mean cord blood IMA values for the IUGR group were significantly increased compared to those in the control group (0.565 ± 0.22 versus 0.250 ± 0.12, respectively, p = .001). There was a significant positive correlation between umbilical artery pulsatility index and IMA levels in the IUGR group. Patients with preeclampsia, oligohydramnios, and abnormal nonstress test results in the IUGR group had significantly higher IMA levels. Patients with systolic to diastolic ratios >3 and pulsatility index (PI) above the 95th percentile in the IUGR group had significantly higher cord blood IMA levels (p = .001 and p = .007, respectively).Conclusions: Cord blood IMA values may be a useful marker for perinatal asphyxia. Abnormal Doppler findings are associated with increased IMA levels in complicated pregnancies with IUGR.
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Affiliation(s)
- Esra Andıç
- Department of Obstetric and Gynecology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Erbil Karaman
- Department of Obstetric and Gynecology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Ali Kolusarı
- Department of Obstetric and Gynecology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Erdem Çokluk
- Department of Biochemistry, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
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Coverdale JPC, Katundu KGH, Sobczak AIS, Arya S, Blindauer CA, Stewart AJ. Ischemia-modified albumin: Crosstalk between fatty acid and cobalt binding. Prostaglandins Leukot Essent Fatty Acids 2018; 135:147-157. [PMID: 30103926 PMCID: PMC6109191 DOI: 10.1016/j.plefa.2018.07.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/17/2018] [Accepted: 07/17/2018] [Indexed: 02/06/2023]
Abstract
Myocardial ischemia is difficult to diagnose effectively with still few well-defined biochemical markers for identification in advance, or in the absence of myocardial necrosis. "Ischemia-modified albumin" (IMA), a form of albumin displaying reduced cobalt-binding affinity, is significantly elevated in ischemic patients, and the albumin cobalt-binding (ACB) assay can measure its level indirectly. Elucidating the molecular mechanism underlying the identity of IMA and the ACB assay hinges on understanding metal-binding properties of albumin. Albumin binds most metal ions and harbours four primary metal binding sites: site A, site B, the N-terminal site (NTS), and the free thiol at Cys34. Previous efforts to clarify the identity of IMA and the causes for its reduced cobalt-binding capacity were focused on the NTS site, but the degree of N-terminal modification could not be correlated to the presence of ischemia. More recent work suggested that Co2+ ions as used in the ACB assay bind preferentially to site B, then to site A, and finally to the NTS. This insight paved the way for a new consistent molecular basis of the ACB assay: albumin is also the main plasma carrier for free fatty acids (FFAs), and binding of a fatty acid to the high-affinity site FA2 results in conformational changes in albumin which prevent metal binding at site A and partially at site B. Thus, this review advances the hypothesis that high IMA levels in myocardial ischemia and many other conditions originate from high plasma FFA levels hampering the binding of Co2+ to sites A and/or B. This is supported by biophysical studies and the co-association of a range of pathological conditions with positive ACB assays and high plasma FFA levels.
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Affiliation(s)
| | - Kondwani G H Katundu
- School of Medicine, University of St Andrews, St Andrews, United Kingdom; College of Medicine, University of Malawi, Blantyre, Malawi
| | - Amélie I S Sobczak
- School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Swati Arya
- School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | | | - Alan J Stewart
- School of Medicine, University of St Andrews, St Andrews, United Kingdom.
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