Assessment of Maternal and Neonatal Oxidative Stress and Antioxidant Defence during Caesarean section

Abstract

Background: Pregnancy is a physiological state in which there is an increased redox imbalance in utero. Foetal oxygenation is fully dependent upon integrity of uteroplacental circulation. Hypoxia is one of the main factor which induces free radical generation in the perinatal period. Studies have shown there is an increase in malondialdehyde (MDA) level, a marker of oxidative stress in vaginal delivery than elective caesarean section Hence the present study was aimed at quantifying the changes with respect to oxidative stress as well as antioxidant status for both mother and newborn during delivery by a caesarean section.Methods. Uncomplicated term pregnant women who delivered either by  elective or emergency lower segment caesarean section (n=20) were included in the study. Plasma malondialdehyde (MDA) for lipid peroxidation (LPO) and other antioxidant enzymes such as Superoxide dismutase (SOD), Glutathione Peroxidase (GPx) and total reduced Glutathione (GSH) were estimated in plasma and hemolysate respectively using the spectrophotometric method. Results were analysed by Student ‘t’ test taking p<0.05 as statistically significant.Results: LPO was significantly higher in cord blood when compared to both before (p<0.05) & after delivery (p<0.05) samples. GSH was found to be higher in maternal blood before delivery than after delivery (p<0.001) and cord (p<0.01) blood samples. GPx & SOD did not reach any statistical significance. But GPx in cord blood sample showed significant negative correlation with maternal age in LSCS (r=-.445, p<.05)Conclusion. Pregnancy results in oxidative stress which is further aggravated during delivery by caesarean section and predisposes the neonate to increased oxidative stress when compared to maternal system which is reflected as an alteration in their antioxidant enzyme levels.