Kord Kanı ve Yenidoğan Plazma Beyin Natriüretik Peptid Düzeyleri ile Doğum Şekli Arasındaki İlişki

Year 2024, Volume: 46 Issue: 1, 118 - 124, 16.01.2024

Meryem Erat , İlke Mungan Akın , Hatica Sibel Sevük Özumut , Banu Isbilen Basok , Ferruh Isman , Derya Büyükkayhan

https://doi.org/10.20515/otd.1374394

Abstract

Fetal-neonatal adaptasyon birçok kompleks mekanizmayı içermektedir. Kardiyovasküler biyomarkırlar perinatal geçiş dönemindeki fetal ve anne fizyolojisinin anlaşılmasına yardımcı olabilir. Bu çalışmada amacımız sağlıklı, zamanında doğmuş yenidoğanlarda doğum şekli ile beyin natriüretik peptid (BNP) düzeyleri arasındaki ilişkiyi değerlendirmektir. Çalışmaya vajinal doğum (n=25) ve sezaryen (n=23) ile doğan 48 yenidoğan dahil edilmiştir. Kordon kanı örneklerinde plazma BNP düzeyleri ölçülmüş ve ayrıca yaşamın ilk gününde yenidoğanların antropometrik ölçümleri ve fizik muayeneleri yapılmıştır. Doğumdan 3 gün sonra BNP düzeyleri ölçümü ve klinik değerlendirme tekrarlanmıştır. Medyan kord ve bebek BNP düzeyleri vajinal ve sezaryen doğumlarda benzer bulunmuştur. Vajinal doğumlarda medyan kord ve bebek BNP düzeyleri arasında fark bulunmamıştır [sırasıyla 54,0 pg/ml (q1-q3: 40,0-111,5) ve 66,0 pg/ml (q1-q3: 43,0-90,0), p=0,619]. Ancak sezaryen doğumlarda, medyan bebek BNP düzeyi, medyan kord BNP düzeyinden istatistiksel olarak anlamlı derecede yüksek bulunmuştur [56,0 pg/ml (q1-q3: 39,0-84,0) ve 75,0 pg/ml (q1-q3: 54,0-145,0), p=0,027]. Komplike olmayan vajinal doğumlar, yüksek BNP seviyeleri ve dolayısıyla fetal kalp sıkıntısı ile ilişkili bulunmamıştır. Elektif sezaryen doğumlarda 3. günde artan BNP düzeyleri postnatal pulmoner ve kardiyak adaptasyonun gecikmesinin habercisi olabilir.

Keywords

Beyin natriüretik peptidi (BNP), vajinal doğum, sezaryen, doğum şekli, yenidoğan

The Association Between Umbilical Cord Blood and Neonatal Plasma Brain Natriuretic Peptide Levels and Mode of Delivery

Abstract

Fetal-to-neonatal adaptation involves many complex mechanisms. Cardiovascular biomarkers may help to understand fetal and maternal physiology in pregnancy and during the perinatal transition period. In this present study, our aim was to assess the association between delivery type and brain natriuretic peptide (BNP) levels in healthy full-term neonates. Forty-eight neonates born by vaginal delivery (n=25) and cesarean section (n=23) were included in the study. Plasma BNP levels were measured at cord blood samples. In addition antropometric measurements and physical examination were evaluated at first day of life. BNP levels measure and clinical evaluation were repeated 3 days later after birth. The median cord and infant BNP levels were similar in vaginal and cesarean delivery. There was no difference between the median cord and infant BNP levels in vaginal deliveries [54.0 pg/ml (q1-q3: 40.0-111.5) and 66.0 pg/ml (q1-q3: 43.0-90.0) respectively, p=0.619]. However, the median infant BNP level was statistically significantly higher than the median cord BNP level [56.0 pg/ml (q1-q3: 39.0-84.0) and 75.0 pg/ml (q1-q3: 54.0-145.0), p=0.027] in cesarean deliveries. Uncomplicated vaginal deliveries were not associated with high BNP levels and thus fetal cardiac distress. Increased levels of BNP levels on the 3rd day in elective cesarean deliveries may be predictive of delayed postnatal pulmonary and cardiac adaptation.

Keywords

Brain natriüretic peptid (BNP), vaginal delivery, cesarean section, mode of delivery, newborn

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