Evaluation of the relationship of fetal thiol-disulfide, thioredoxin reductase and peroxiredoxin-6 values with fetal and maternal outcomes in fetal cord blood in pregestational and gestational diabetes

OBJECTIVE: We aimed to investigate the correlation between dynamic thiol/disulfide hemostasis,peroxyredoxin-6 and thioredoxin reductase values and maternal, fetal adverse outcomes and clinical parameters in cord blood of neonates ofpatients with pregestational and gestational diabetes mellitus. MATERIAL AND METHODS:A total 82 pregnant women(19-Pre GDM, 29 GDM and 34 control)were enrolled in this prospective case control study.Women who were followed up in the outpatient clinic without any detoriation in blood sugar regulation were included the study. Dynamic thiol/disulfide hemostasis,peroxyredoxin-6(PRDX-6) and thioredoxin reductase (TRDX) values in cord blood were examined with automated method.Maternal and neonatal adverse outcomes and their relationship with maternal clinical parameters were evaluated. RESULTS:Peroxyredoxin-6 (PRDX 6 )amounts of the Pre GDM group was significantly higher than the control group (p <0.01),but no significant difference was observed between GDM and the control group (p> 0.05). There was no significant difference between Pre GDM and GDM groups (p> 0.05). The thioredoxin reductase (TRXR) amounts of the Pre GDM group was significantly higher than the GDM group (p <0.05) and the control group (p <0.01). There was a statistically significant difference between Disulfide / Total Thiol and Disulfide / Native Thiol average (p <0.01). The mean of the Pre GDM group was significantly higher than the control group (p <0.01) and the mean of the GDM group was higher than the control group (p <0.01). There was no significant difference between Pre GDM and GDM groups (p> 0.05). There was a statistically significant relationship between Disulfide / Native Thiol and Disulfide / Total Thiol ratios and OGTT 100gr 2nd hour levels and delivery week (p <0.05) Pre GDM and GDM groups have higher perinatal adverse outcome rates than the control group. There was no statistically significant difference between Pre GDM and GDM groups (p> 0.05). CONCLUSION: İnfants born from diabetic mothers are more exposed to oxidative stress. Although high levels of exposure to oxidative stress are higher with Pre GDM patients, neonatal adverse outcomes may not be different in GDM too. When evaluating the clinical parameters, the relationship between OGTT 2.hr value and oxidative pathways should be considered as the guiding role of glucose intolerance mechanism Key words: Gestational diabetes, Thiol/Disulfit Hemostasis , Thioredoxin Reductase,Peroxyredoxin 6,adverse perianatal outcome