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Z Geburtshilfe Neonatol 2021; 225(06): 518-525
DOI: 10.1055/a-1487-7262
Original Article

Comparison of the Effect of Preoperative Anxiety on the Oxidative Stress Biomarkers in Umbilical Cord Blood After Vaginal and Cesarean Delivery

Ökkeş Hakan Miniksar 
1   Department of Anesthesiology and Reanimation, Bozok University, Yozgat, Turkey
,
Demet Aydogan Kırmızı 
2   Department of Obstetrics and Gynecology, Yozgat Bozok University, Faculty of Medicine, Yozgat, Turkey
,
Melike Demir Çaltekin 
2   Department of Obstetrics and Gynecology, Yozgat Bozok University, Faculty of Medicine, Yozgat, Turkey
,
Mahmut Kılıç
3   Department of Public Health, Yozgat Bozok University, Yozgat, Turkey
,
Dilsad Yildiz Miniksar
4   Department of Child and Adolescent Psychiatry, Bozok University, Yozgat, Turkey
,
Ayşe Yeşim Gocmen
5   Department of Biochemistry, Bozok University, Faculty of Medicine, Yozgat, Turkey
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Abstract

Objective This study examined the independent effect of delivery type and preoperative anxiety on placenta oxidative stress response.

Materials and methods A total of 126 patients who gave birth were divided into two groups according to delivery type: vaginal delivery group (VD) (n=56) and elective cesarean section delivery group (CS) (n=70). The preoperative anxiety levels of pregnant women who came to the delivery room were evaluated with the State Anxiety Inventory (SAI) scale. Malonyldialdehyde (MDA), superoxide dismutase (SOD), total antioxidative status (TAS), total oxidative state (TOS), and oxidative stress index (OSI) levels in umbilical cord blood were compared according to preoperative anxiety level and type of delivery.

Results The CS group had significantly higher MDA (0.88±0.15 versus 0.79±0.09, p=0.001) and TOS (8.37±1.81 versus 7.53±0.77, p=0.019) values compared to the VD group. TAS levels did not differ significantly between the groups. SOD levels were higher in VD group compared to CS group (p=0.049). When the factors affecting oxidative stress biomarkers are analyzed by regression analysis, factors affecting MDA were found to be SAI score (Beta=0.358), CS (Beta=0.212), the factor affecting SOD was found to be VD (Beta=0.318), the factors affecting TOS were found to be SAI score (Beta=0.317) and CS (Beta=0.183).

Conclusıon Oxidative stress biomarker levels in umbilical cord blood and preoperative anxiety levels were higher in patients who underwent elective caesarean section than those who delivered vaginally. Preoperative anxiety was the factor that increased oxidative stress biomarkers of umbilical cord blood the most.

Key words

Preoperative anxiety - oxidative stress - cesarean delivery - vaginal delivery


Publication History

Received: 25 November 2020

Accepted after revision: 03 April 2021

Article published online:
28 May 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Toescu V, Nuttall SL, Martin U. et al. Oxidative stress and normal pregnancy. Clin Endocrinol 2002; 57: 609-613
    CrossrefPubMedGoogle Scholar
  • 2 Samir D. Study of oxidative stress during pregnancy. Glob J Pharm Pharm Sci 2018; 4: e555646
    PubMedGoogle Scholar
  • 3 Bakunina N, Pariante CM, Zunszain PA. Immune mechanisms linked to depression via oxidative stress and neuroprogression. Immunology 2015; 144: 365-373
    CrossrefPubMedGoogle Scholar
  • 4 Al-Gubory KH, Fowler PA, Garrel C. The roles of cellular reactive oxygen species, oxidative stress and antioxidants in pregnancy outcomes. Int J Biochem Cell Biol 2010; 42: 1634-1650
    CrossrefPubMedGoogle Scholar
  • 5 Jain S, Nair A, Shrivastava C. Evaluation of oxidative stress marker malondialdehyde level in the cord blood of newborn infants. Int J Sci Study 2015; 3: 73-76
    PubMedGoogle Scholar
  • 6 Katzer D, Mueller A, Welzing L. et al. Antioxidative status and oxidative stress in the fetal circulation at birth: the effects of time of delivery and presence of labor. Early Hum Dev 2015; 91: 119-124
    CrossrefPubMedGoogle Scholar
  • 7 Hung TH, Chen SF, Hsieh TT. et al. The associations between labor and delivery mode and maternal and placental oxidative stress. Reprod Toxicol 2011; 31: 144-150
    CrossrefPubMedGoogle Scholar
  • 8 Hu Y, Huang K, Sun Y. et al. Placenta response of inflammation and oxidative stress in low-risk term childbirth: The implication of delivery mode. BMC Pregnancy Childbirth 2017; 17: 1-10
    PubMedGoogle Scholar
  • 9 Mutlu B, Aksoy N, Cakir H. et al. The effects of the mode of delivery on oxidative-antioxidative balance. J Matern Neonatal Med 2011; 24: 1367-1370
    CrossrefPubMedGoogle Scholar
  • 10 Mehmetolu Ý, Kart A, Çalayan O. et al. Oxidative stress in mothers and their newborns in different types of labour. Turkish J Med Sci 2002; 32: 427-429
    PubMedGoogle Scholar
  • 11 Veleminsky M, Ambroz A, Rossner P. et al. Oxidative stress in newborns by different modes of delivery. Neuroendocrinol Lett 2016; 37: 445-451
    PubMedGoogle Scholar
  • 12 Wilinska M, Borszewska-Kornacka MK, Niemiec T. et al. Oxidative stress and total antioxidant status in term newborns and their mothers. Ann Agric Environ Med 2015; 22: 736-740
    CrossrefPubMedGoogle Scholar
  • 13 Adekanle DA, Oparinde DP, Atiba AS. et al. Effect of different modes of delivery on cord blood oxidative stress markers. Int J Biomed Sci 2013; 9: 249-254
    CrossrefPubMedGoogle Scholar
  • 14 Gülbayzar S, Arica V, Hatipoğlu S. et al. Malondialdehyde level in the cord blood of newborn infants. Iran J Pediatr 2011; 21: 313-319
    PubMedGoogle Scholar
  • 15 Kulaçoglu H, Ozdogan M, Gurer A. et al. Prospective comparison of local, spinal, and general types of anaesthesia regarding oxidative stress following Lichtenstein hernia repair. Bratis. Lek Listy 2007; 108: 335-339
    PubMedGoogle Scholar
  • 16 Sun Y, Huang K, Hu Y. et al. Pregnancy-specific anxiety and elective cesarean section in primiparas: a cohort study in China. PLoS One 2019; 14: 1-13
    CrossrefPubMedGoogle Scholar
  • 17 Horsch A, Gilbert L, Lanzi S. et al. Prospective associations between maternal stress during pregnancy and fasting glucose with obstetric and neonatal outcomes. J Psychosom Res 2019; 125: e109795
    CrossrefPubMedGoogle Scholar
  • 18 Van Den Bergh BRH, Mulder EJH, Mennes M. et al. Antenatal maternal anxiety and stress and the neurobehavioural development of the fetus and child: links and possible mechanisms. A review. Neurosci Biobehav Rev 2005; 29: 237-258
    CrossrefPubMedGoogle Scholar
  • 19 O Pimenta BS, Y Nomura RM, Nakamura MU. et al. Maternal anxiety and fetal movement patterns in late pregnancy. J Matern Neonatal Med 2016; 29: 2008-2012
    CrossrefPubMedGoogle Scholar
  • 20 Ding XX, Wu YLe, Xu SJ. et al. Maternal anxiety during pregnancy and adverse birth outcomes: a systematic review and meta-analysis of prospective cohort studies. J Affect Disord 2014; 159: 103-110
    CrossrefPubMedGoogle Scholar
  • 21 Crandon AJ. Maternal anxiety and obstetric complications. J Psychosom Res 1979; 23: 109-111
    CrossrefPubMedGoogle Scholar
  • 22 Wyatt SS, Jones DA, Peach MJ. et al. Anxiety in patients having caesarean section under regional anaesthesia: a questionnaire and pilot study. Int J Obstet Anesth 2001; 10: 278-283
    CrossrefPubMedGoogle Scholar
  • 23 Bouayed J, Rammal H, Soulimani R. Oxidative stress and anxiety: relationship and cellular pathways. Oxid Med Cell Longev 2009; 2: 63-67
    CrossrefPubMedGoogle Scholar
  • 24 Ng F, Berk M, Dean O. et al. Oxidative stress in psychiatric disorders: Evidence base and therapeutic implications. Int J Neuropsychopharmacol 2008; 11: 851-876
    PubMedGoogle Scholar
  • 25 Fedoce A, das G, Ferreira F, Bota RG. et al. The role of oxidative stress in anxiety disorder: cause or consequence?. Free Radic Res 2018; 52: 737-750
    CrossrefPubMedGoogle Scholar
  • 26 Ulubas Isik D, Akdaş Reis Y, Bas AY. et al. The effect of the modes of delivery on the maternal and neonatal dynamic thiol–disulfide homeostasis. J Matern Neonatal Med 2019; 32: 3993-3997
    CrossrefPubMedGoogle Scholar
  • 27 Golalizadeh F, Shobeiri F, Ranjbar A. et al. Maternal parity and blood oxidative stress in mother and neonate. Biotechnol Heal Sci 2016; 3: 1-6
    PubMedGoogle Scholar
  • 28 Perrone S, Negro S, Tataranno ML. et al. Oxidative stress and antioxidant strategies in newborns. J Matern Neonatal Med 2010; 23: 63-65
    CrossrefPubMedGoogle Scholar
  • 29 Nast I, Bolten M, Meinlschmidt G. et al. How to measure prenatal stress? A systematic review of psychometric instruments to assess psychosocial stress during pregnancy. Paediatr Perinat Epidemiol 2013; 27: 313-322
    CrossrefPubMedGoogle Scholar
  • 30 Bayrak M, Sancak A. Association between antenatal maternal anxiety and fetal middle cerebral artery Doppler depends on fetal gender. J Matern Neonatal Med 2020; DOI: 10.1080/14767058.2020.1716331.
    CrossrefPubMedGoogle Scholar
  • 31 Gitau R, Menson E, Pickles V. et al. Umbilical cortisol levels as an indicator of the fetal stress response to assisted vaginal delivery. Eur J Obstet Gynecol Reprod Biol 2001; 98: 14-17
    CrossrefPubMedGoogle Scholar
  • 32 Okudaira S, Suzuki S. Influence of spinal hypotension on fetal oxidative status during elective cesarean section in uncomplicated pregnancies. Arch Gynecol Obstet 2005; 271: 292-295
    CrossrefPubMedGoogle Scholar
  • 33 Soxhuku A, Misja A, Shpata V. et al. The role of maternal preoperative anxiety on hypotension after spinal anaesthesia in caesarean delivery. Int J Heal. Sci Res 2016; 6: 118
    PubMedGoogle Scholar
  • 34 Sjöström K, Valentin L, Thelin T. et al. Maternal anxiety in late pregnancy and fetal hemodynamics. Eur J Obstet Gynecol Reprod Biol 1997; 74: 149-155
    CrossrefPubMedGoogle Scholar
  • 35 Sridhar MG, Setia S, John M. et al. Oxidative stress varies with the mode of delivery in intrauterine growth retardation: Association with Apgar score. Clin Biochem 2007; 40: 688-691
    CrossrefPubMedGoogle Scholar