Effects of mode of delivery on pro-oxidant/antioxidant balance in fetal circulation

Abstract

Objective: This study was undertaken to assess the influence of mode of delivery on the balance between pro-oxidant/antioxidant systems in fetal circulation.

Materials and methods: Both umbilical arterial and venous blood samples were obtained from 37 pregnant women who delivered by spontaneous vaginal delivery (VD group) and from 29 pregnant women who delivered by elective cesarean section (CS group). Oxidative stress and antioxidant activity were evaluated by reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP), respectively.

Results: The d-ROMs values of the VD group were higher than that of the CS group in both umbilical arterial and venous blood and these differences were found to be statistically significant (p < .01 and p < .01, respectively). The BAP values of only the umbilical arterial blood were found to be statistically significant (p < .01), with values from the VD group being higher than those of the CS group. In all measurements, the d-ROMs values averaged below 120 CARR U and BAP values averaged above 2200 µmol/L. The ratio of BAP/d-ROMs difference was found to be statistically significant (p < .01) only in the umbilical venous blood, with ratios in the VD group being lower than those in the CS group.

Conclusions: Our statistical analyses suggest that vaginal delivery has an effect on increasing oxidative stress as a result of the stress of labor and that an elective cesarean section does not impair the mother’s oxidative stress status. Furthermore, the high BAP values in all the measurements suggest that neonates just after birth have the ability to cope with oxidative stress.

Rationale

•   In many studies, the diversity of views on the influence of mode of delivery on the redox status of neonates is likely to be caused by the use of different biomarkers to measure either the oxidative stress, the antioxidant activity, or both. Furthermore, incomplete explanation for sampling cord blood in these studies, either arterial, venous blood or both, complicates matters. To solve the above, this study was designed to assess the effects of mode of delivery on both pro-oxidants, via d-ROMs, and antioxidants, via BAP, in both umbilical arterial and venous blood samples obtained just after birth. There are no existing studies of BAP in both umbilical arterial and venous blood to which we can refer. In conclusion, our study suggests that the pro-oxidant/antioxidant balance in neonates just after birth is better than may be expected when compared to the potentials of adults (including pregnant mothers) according to interpretations of BAP/d-ROMs. This can be understood that neonates may have already been endowed with the ability to cope with oxidative stress, as informed by high BAP values in both umbilical arterial and venous blood. Vaginal delivery may have an effect on increasing oxidative stress as a result of the stress of labors (as measured by d-ROMs), and an elective cesarean section, which has better BAP/d-ROMs in umbilical venous blood than that of vaginal delivery, may not impair the mother’s oxidative stress status.

Keywords:

• Biological antioxidant potential (BAP)
• cesarean section
• oxidative stress status
• reactive oxygen metabolites (d-ROMs)
• vaginal delivery

Acknowledgements

We acknowledge Kenji Ishii, MD, Yoshitaka Kataoka, MD, Keiko Saito, MD, and Yoko Saito, MD for collecting blood samples from subjects.

Disclosure statement

No potential conflict of interest was reported by the authors.