The effect of labour type and duration on maternal and fetal oxidative stress

Objective: Labour and parturition are conditions which cause oxidative stress for both mother and her baby. HIF-1 α and adrenomedullin are biological molecules that is used to measure oxidative stress. The aim of this study is to determine whether there is a difference in the levels of maternal and neonatal serum HIF-1α and adrenomedullin according to labour type. Materials and Method: A total of 60 healthy pregnant volunteers consisted of 20 pregnant women with normal vaginal delivery, 20 pregnant women with elective C/S, and 20 pregnant women with emergency C/S were included in this prospective study. The blood samples of the participants were taken before, during and after the delivery and the neonatal blood sample was taken from umbilical cord immediately after birth. The blood levels of the HIF1-α and adrenomedullin were measured and compared among groups according to the labour types. Results: There were no statistically significant differences in the levels of HIF1- α obtained before delivery, during delivery, and postpartum among groups (for all p>0,05) and the fetal levels of HIF1- α also did not statistically differ among groups (p>0,05). The blood adrenomedullin levels obtained before delivery, during delivery and postpartum were significantly higher in the elective C/S group than other groups (for all p>0,05). The fetal blood adrenomedullin levels were significantly higher in the emergency C/S group compared to other groups (p<0,05). When the blood samples obtained before and during delivery were compared within groups, the HIF1-α levels obtained before delivery were significantly higher compared to those obtained during delivery in the vaginal birth group (p<0.05). The HIF1-α levels obtained postpartum were also significantly higher than those obtained during delivery in the vaginal birth group (p<0,05). In all within group analyses, there were no statistically significant differences in the levels of adrenomedullin among before delivery, during delivery, and postpartum (for all p>0.05). Conclusion: In the case of delayed labour resulted from any reason, it is important to manage C/S immediately in terms of the prevention of mother and fetus from the oxidative stress. The effects of adrenomedullin and HIF1-α on labour are different. This finding suggests that these molecules use different pathways to exhibit their role in oxidative stress. Further studies are required to clarify this issue.