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Pietryga M, Tobola-Wrobel K, Dydowicz P, Radzicka-Mularczyk S, Ziolkowska K, Napierala M, Florek E, Brazert J. Can redox imbalance predict abnormal foetal development? Ginekol Pol 2022; 93:209-216. [PMID: 35072234 DOI: 10.5603/gp.a2021.0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/16/2021] [Accepted: 04/24/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Based on the current state of knowledge, elevated levels of oxidative stress markers may be considered as risk factors for pregnancy complications. The aim of the research was to assess the correlation between selected oxidative stress biomarkers with the occurrence of foetal chromosomal aberration and congenital malformations. MATERIAL AND METHODS This retrospective research lasted for two years. The purpose was to determine serum levels of selected oxidative stress markers, including total protein (TP), glutathione (GSH), S-nitrosothiols (RSNO), nitric oxide (NO), trolox equivalent antioxidant capacity (TEAC) and glutathione S-transferase (GST) at 11-13 + 6 gestational weeks in 38 women with confirmed foetal developmental abnormalities and in 34 healthy pregnancies in order to assess their utility as predictors of abnormal foetal development. RESULTS Serum concentrations of TP (56.90 ± 5.30 vs 69.1 ± 15.30 mg/mL), TEAC (4.93 ± 0.82 vs 5.64 ± 0.74 μM/mL) and GST (15.94 ± 4.52 vs 21.72 ± 6.81 nM/min/mg) were statistically significantly (p < 0.05) lower in the group of patients with developmental abnormalities in the fetus, whereas GSH levels (6.43 ± 1.24 vs 4.98 ± 1.88 nM/mg) were significantly higher, compared to the group of healthy fetuses. There were no differences in the concentration of these markers between chromosomal aberrations and fetal dysmorphia in subjects. A significant difference in odds ratio obtained for GSH (OR = 0.57, 95% CL: 0.40-0.80) indicates that its higher concentration can relate to reduced risk of developmental abnormalities, whereas odds ratio for TP (OR=1.11, 95% CL: 1.04-1.17), TEAC (OR = 3.54, 95% CL: 1.56-8.05) and GST (OR = 1.18, 95% CL: 1.03-1.17) indicate that their elevation may increase the risk of developmental abnormalities CONCLUSIONS: Elevated levels of TP, GST, TEAC and low GSH level may be relevant to predict congenital defects.
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Affiliation(s)
| | | | | | | | | | | | - Ewa Florek
- Poznan University of Medical Sciences, Poland, Poland
| | - Jacek Brazert
- Poznan University of Medical Sciences, Poland, Poland
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Ziolkowska K, Tobola-Wrobel K, Dydowicz P, Zurawski S, Pietryga M, Wysocka E. The significance of maternal blood pregnancy-associated plasma protein A (PAPP-A) and free beta-subunit of human chorionic gonadotropin (β-hCG) levels for the risk assessment of fetal trisomy 18 during the first prenatal testing between 11 and 13+6 weeks of pregnancy. Ginekol Pol 2021; 91:748-754. [PMID: 33447994 DOI: 10.5603/gp.a2020.0126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/12/2020] [Accepted: 07/14/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aim of the study was to evaluate the significance of the maternal blood level of pregnancy-associated plasma protein A (PAPP-A) and free beta-subunit of human chorionic gonadotropin (β-hCG), to estimate the risk of fetal trisomy 18 and their correlation with the assessment of nuchal translucency (NT) during the first prenatal testing. MATERIAL AND METHODS Examinations of 93 pregnant women between 11 and 13+6 weeks of pregnancy were conducted, which included determination of β-hCG and PAPP-A concentrations in the maternal serum and ultrasound assessment of fetal nuchal translucency. Concentrations of biochemical parameters were expressed as multiples of median (MoM) for the appropriate gestational age. The risk assessment of trisomy 18 was analyzed using Astraia software. Pregnant women with a high (≥ 1:300) risk of trisomy 18 were offered a genetic amniocentesis with an examination of fetal karyotype. Twenty cases were healthy and 23 with trisomy 18. RESULTS PAPP-A and β-hCG MoM values < 0.3 were found in 61% cases of fetal trisomy 18. In 26% of cases, PAPP-A and β-hCG MoM values < 0.2 were NT-independent risk factors for trisomy 18. There were no significant differences between groups with normal fetal karyotype (40%) and trisomy 18 (35%) in PAPP-A and β-hCG MoM 0.2-0.5 range. CONCLUSIONS Maternal free β-hCG MoM was found to change parallelly to fetal NT widening in case of trisomy 18 diagnosis. Maternal β-hCG and PAPP-A MoM results presented less then 0.2 might be used independently of NT widening in fetus for trisomy 18 risk evaluation. Above 0.2 for PAPP-A and β-hCG MoMs, fetal NT measurement was an requirment.
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Affiliation(s)
- Katarzyna Ziolkowska
- Chair and Department of Laboratory Diagnostics, Poznan University of Medical Sciences, Poznan, Poland.
| | - Kinga Tobola-Wrobel
- Department of Obstetrics and Women's Health, Chair of Gynaecology, Obstetrics and Gynaecological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Dydowicz
- Prenatal Diagnostic Centre, Gynaecology and Obstetrics Hospital, Poznan University of Medical Sciences, Poznan, Poland
| | - Sebastian Zurawski
- Chair and Department of Laboratory Diagnostics, Poznan University of Medical Sciences, Poznan, Poland
| | - Marek Pietryga
- Prenatal Diagnostic Centre, Gynaecology and Obstetrics Hospital, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewa Wysocka
- Chair and Department of Laboratory Diagnostics, Poznan University of Medical Sciences, Poznan, Poland
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Gasiorowska A, Zawiejska A, Dydowicz P, Wender-Ożegowska E, Poprawski G, Tobola-Wrobel K, Radzicka-Mularczyk S, Ziołkowska K, Pietryga M. Mid-trimester ultrasound parameters for predicting birth weight in low risk pregnancies vs high-risk pregnancies complicated with pre-gestational diabetes mellitus. Ginekol Pol 2020; 91:216-222. [PMID: 32374022 DOI: 10.5603/gp.2020.0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/11/2020] [Accepted: 03/13/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of the study was to assess the utility of mid-trimester ultrasound parameters in predicting birth weight in low-risk pregnancy and high-risk pregnancy complicated with pregestational diabetes mellitus. MATERIAL AND METHODS A study group comprised 97 healthy women and 160 women with pregestational diabetes (PGDM, type 1), all in singleton pregnancy. Ultrasound examination was performed between weeks 11 and 14, and in weeks 20 and 30 of gestation, based on recommendations of the Polish Society of Gynecologists and Obstetricians, Ultrasonography Division. We also checked uterine artery blood flow parameters. RESULTS There is a correlation between the birth weight and ultrasound-ascertained parameters, including those characterising uterine artery blood flow and foetal biometry [abdominal circumference (AC), femoral length (FL), biparietal dimension (BPD)].The biparietal dimension (BPD), head circumference (HC) abdominal circumference (AC) and pre-existing diabetes are the ultrasound predictors of LGA. The presence of an early-diastolic uterine artery blood flow waveform notching, as well as the uterine artery pulsatility index (UAPI), femoral length (FL) and hypertension in pregnancy are the ultrasound predictors of SGA. In the subset of women with pre-gestational diabetes (PGDM), there is a negative correlation between the birth weight and the uterine artery pulsatility index and early-diastolic uterine artery blood flow waveform notching. In women with pre-gestational diabetes mellitus (PGDM), femoral length (FL) is a significant predictor of LGA and in case of SGA significant predictors are uterine artery pulsatility index, artery blood flow waveform notching and femoral length (FL). CONCLUSIONS Midtrimester ultrasound parameters with confirmed usefulness in the prediction of birth weight in low-risk pregnancy and high-risk pregnancy complicated with pregestational diabetes mellitus include: uterine artery PI, early-diastolic uterine artery blood flow waveform notching and foetal biometry.
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Affiliation(s)
- Anna Gasiorowska
- Gynaecology and Obstetrics Ward, Specialist Hospital, Zakopane, Poland.
| | - Agnieszka Zawiejska
- Department of Reproduction, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Dydowicz
- Prenatal Diagnostic Centre, Gynaecology and Obstetrics Hospital, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewa Wender-Ożegowska
- Department of Reproduction, Poznan University of Medical Sciences, Poznan, Poland
| | - Grzegorz Poprawski
- Chair and Department of Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Kinga Tobola-Wrobel
- Department of Obstetrics and Women's Health, Chair of Gynaecology, Obstetrics and Gynaecological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Sandra Radzicka-Mularczyk
- Department of Obstetrics and Women's Health, Chair of Gynaecology, Obstetrics and Gynaecological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Ziołkowska
- Chair and Department of Laboratory Diagnostics, Poznan University of Medical Sciences, Poznan, Poland
| | - Marek Pietryga
- Prenatal Diagnostic Centre, Gynaecology and Obstetrics Hospital, Poznan University of Medical Sciences, Poznan, Poland.,Department of Obstetrics and Women's Health, Chair of Gynaecology, Obstetrics and Gynaecological Oncology, Poznan University of Medical Sciences, Poznan, Poland
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Gasiorowska A, Zawiejska A, Dydowicz P, Wender-Ozegowska E, Poprawski G, Tobola-Wrobel K, Ziolkowska K, Pietryga M. Maternal factors, ultrasound and placental function parameters in early pregnancy as predictors of birth weight in low-risk populations and among patients with pre-gestational diabetes. Ginekol Pol 2020; 90:388-395. [PMID: 31392708 DOI: 10.5603/gp.2019.0067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 07/01/2019] [Accepted: 07/03/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of our work was to assess the usefulness of maternal factors, ultrasound and placental function parameters during early pregnancy as predictors of birth weight in populations of healthy pregnant women and women suffering from pregestational diabetes. MATERIAL AND METHODS A study group comprised 97 healthy women and 160 women with pregestational diabetes (PGDM, type 1), all in singleton pregnancy. Ultrasound examination was performed between weeks 11 and 14, and in weeks 20 and 30 of gestation, based on recommendations of the Polish Society of Gynecologists and Obstetricians, Ultrasonography Division. We also checked uterine artery blood flow parameters. During the first trimester consultation, all patients were surveyed and the following data were collected: age, BMI, reproductive history, comorbidities and smoking. We also collected blood samples and assessed PlGF, PAPP-A, and BhCG levels. RESULTS Our study showed that newborn birth weight negatively correlated with mother's age, her diastolic blood pressure, PI of her uterine arteries and BhCG protein levels. Moreover, birth weight directly correlated with PlGF and PAPPA-A protein levels, and maternal early-pregnancy BMI. CONCLUSIONS LGA diagnosis in the first trimester of pregnancy allows for selection and modification of some risk factors and closer monitoring of endangered fetuses throughout the pregnancy, with emphasis on the perinatal period. Parameters with confirmed usefulness in the prediction of birth weight in the first trimester included: maternal age, BMI, blood pressure, PAPP-A, BhCG and PlGF levels, fetal CRL and uterine artery PI.
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Affiliation(s)
- Anna Gasiorowska
- Gynecology and Obstetrics Ward, Podhalanski Specialist Hospital, Nowy Targ, Poland.
| | | | - Piotr Dydowicz
- Prenatal Diagnostic Center, Gynecology and Obstetrics Hospital, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Grzegorz Poprawski
- Chair and Clinic of Oncology, Poznan University of Medical Sciences, Poznan
| | - Kinga Tobola-Wrobel
- Department of Obstetrics and Women's Disorders, Chair of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Ziolkowska
- Chair and Department of Laboratory Diagnostics, Poznan University of Medical Sciences, Poznan, Poland
| | - Marek Pietryga
- Prenatal Diagnostic Center, Gynecology and Obstetrics Hospital, Poznan University of Medical Sciences, Poznan, Poland.,Department of Obstetrics and Women's Disorders, Chair of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, Poznan, Poland
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Ziolkowska K, Dydowicz P, Sobkowski M, Tobola-Wrobel K, Wysocka E, Pietryga M. The clinical usefulness of biochemical (free β-hCg, PaPP-a) and ultrasound (nuchal translucency) parameters in prenatal screening of trisomy 21 in the first trimester of pregnancy. Ginekol Pol 2020; 90:161-166. [PMID: 30950006 DOI: 10.5603/gp.2019.0029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 03/13/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of the study was to analyze the correlation of multiples of the normal median of PAPP-A, free β-hCG levels and nuchal translucency values in prenatal, first trimester screening of trisomy 21 in pregnant women. MATERIAL AND METHODS 251 pregnant women underwent antenatal screening at 11-13+6 weeks of pregnancy which was composed of the measurement of free β-human chorionic gonadotropin (β-hCG) and pregnancy-associated plasma protein (PAPP-A) levels in the maternal serum and an ultrasound assessment of nuchal translucency (NT). The pregnant women with a high risk of trisomy 21 (≥ 1:300) were given amniocentesis to verify fetal defects. There were 217 cases of normal fetal karyotype and 34 cases of trisomy 21. PAPP-A, β-hCGMoM and NT values were analyzed for the predefined ranges. RESULTS 85% cases of trisomy 21 had elevated free β-hCGMoM (> 1.5) and only 53% of these had a PAPP-AMoM result below 0.5 (p < 0.05). Analysis of NT in selected ranges of β-hCG (> 1.5) and PAPP-AMoM (< 0.05), which are typical for Down Syndrome values, showed that not all fetuses with Down Syndrome presented with an increased NT. Respectively 44.15% and 26.5% of fetuses presented with increased NT. Characteristic for trisomy 21, a correlation with all 1st trimester screening tests' parameters occurred in only 23.5% of cases. In 53% of cases the results were atypical. CONCLUSIONS The PAPP-A and β-hCG values in the selected MoM ranges did not shown a correlation to the NT measurement, therefore they are independent factors in the diagnosis of trisomy 21. Simultaneous biochemical and ultrasound testing is an indispensable condition for prenatal diagnosis of trisomy 21 in the 1st trimester of pregnancy.
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Affiliation(s)
- Katarzyna Ziolkowska
- Chair and Department of Laboratory Analyses, Poznan University of Medical Sciences, Poznan, Poland.
| | - Piotr Dydowicz
- Chair and Department of Laboratory Analyses, Poznan University of Medical Sciences, Poznan, Poland
| | - Maciej Sobkowski
- Chair and Department of Laboratory Analyses, Poznan University of Medical Sciences, Poznan, Poland
| | - Kinga Tobola-Wrobel
- Chair and Department of Laboratory Analyses, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewa Wysocka
- Chair and Department of Laboratory Analyses, Poznan University of Medical Sciences, Poznan, Poland
| | - Marek Pietryga
- Chair and Department of Laboratory Analyses, Poznan University of Medical Sciences, Poznan, Poland
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Pietryga M, Dydowicz P, Toboła K, Napierała M, Miechowicz I, Gąsiorowska A, Brązert M, Florek E. Selected oxidative stress biomarkers in antenatal diagnosis as 11-14 gestational weeks. Free Radic Biol Med 2017; 108:517-523. [PMID: 28428000 DOI: 10.1016/j.freeradbiomed.2017.04.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 04/03/2017] [Accepted: 04/16/2017] [Indexed: 10/19/2022]
Abstract
The primary objective in modern obstetrics and prenatal diagnosis is to predict risks of congenital abnormalities. The aim of the research was to assess the correlation between selected oxidative stress biomarkers with the risk of foetal chromosomal aberration evaluated at the first trimester screening. A series of studies show that balanced free radical activity and oxidative homeostasis are essential for proper bodily growth and function. Reactive oxygen species (ROS) may be one of the factors associated with disruption of cell cycle and tissue development, thus leading to developmental abnormalities. That's why it's so important to examine connection between level of oxidative stress and congenital abnormalities. Using ultrasonography examinations between 11-13+6d gestational weeks combined with serum levels of pregnancy associated plasma protein A and human chorionic gonadotropin and spectrophotometric analysis of oxidative stress markers such as glutathione (GSH), S-transferase, S-nitrosothiols (RSNO), trolox equivalent antioxidant capacity (TEAC), protein and nitrites we tried to find correlation between birth defects and oxidative stress status. In conclusion, our analysis suggests that elevated maternal serum levels of protein, S-transferase and TEAC as well as decreased maternal serum levels of GSH and protein correlated with the risk of chromosomal aberrations and congenital developmental defects in a foetus.
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Affiliation(s)
- Marek Pietryga
- Ultrasound and Prenatal Diagnostic Laboratory, Gynaecology and Obstetrics Hospital K. Marcinkowski Poznań University of Medical Sciences, Poland; Department of Obstetrics and Female Health, Chair of Gynaecology, Obstetrics and Gynaecological Oncology, K. Marcinkowski Poznań University of Medical Sciences, Poland.
| | - Piotr Dydowicz
- Ultrasound and Prenatal Diagnostic Laboratory, Gynaecology and Obstetrics Hospital K. Marcinkowski Poznań University of Medical Sciences, Poland; Department of Gynaecology and Obstetrics, Chair of Medical Education, Faculty of Health Sciences, K. Marcinkowski Poznań University of Medical Sciences, Poland.
| | - Kinga Toboła
- Ultrasound and Prenatal Diagnostic Laboratory, Gynaecology and Obstetrics Hospital K. Marcinkowski Poznań University of Medical Sciences, Poland; Department of Obstetrics and Female Health, Chair of Gynaecology, Obstetrics and Gynaecological Oncology, K. Marcinkowski Poznań University of Medical Sciences, Poland.
| | - Marta Napierała
- Laboratory of Environmental Research, Department of Toxicology, K. Marcinkowski Poznań University of Medical Sciences, Poland.
| | - Izabela Miechowicz
- Department of Computer Science and Statistics, K. Marcinkowski Poznań University of Medical Sciences, Poland.
| | - Anna Gąsiorowska
- Gynaecology and Obstetrics Ward, Podhalański Specialist Hospital in Nowy Targ, Poland.
| | - Maciej Brązert
- Department of Reproductive Medicine, Chair of Gynaecology, Obstetrics and Gynaecological Oncology, K. Marcinkowski Poznań University of Medical Sciences, Poland.
| | - Ewa Florek
- Laboratory of Environmental Research, Department of Toxicology, K. Marcinkowski Poznań University of Medical Sciences, Poland.
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Gąsiorowska A, Pietryga M, Zawiejska A, Dydowicz P, Ziółkowska K, Wolski H, Brązert J. Chorionic thickness and PlGF concentrations as early predictors of small-for-gestational age birth weight in a low risk population. Ginekol Pol 2017; 88:87-95. [DOI: 10.5603/gp.a2017.0021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 02/05/2017] [Indexed: 11/25/2022] Open
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Jedrzejczak P, Szumała-Kakol A, Dydowicz P, Szymanowski K, Pisarski T. [Usefulness of counting leukocytes and round cells in determination of bacterial infection of semen in infertile men]. Ginekol Pol 1996; 67:569-73. [PMID: 9289444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The authors measured efficiency of the determination of bacterial infection from the semen of infertile men. They compared the correlation of counts of bacteria with white blood cells (peroxidase method) and round cells in ejaculate. Seminal white blood cells counts (more than 1 x 10(5)/ml) correlated well with bacteriospermia (more than 1000 cells/ml), R = 0.4741, p = 0.0007. Determination of round cells in semen has no clinical value in prediction of seminal infection, R = 0.0153, p = 0.6022.
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