ABSTRACT
Oxidative stress plays a key direct and indirect role in the pathogenesis of several diabetes and pregnancy related complications in both diabetic mothers and their infants. Forty women and their newborn infants divided into two groups were studied. Group I included 20 diabetic women and their newborn infants. Group II consisted of 20 clinically healthy women and their twenty newborns as controls. All involved mothers and newborns were subjected to detailed history, thorough clinical examination, routine laboratory investigations, imaging studies, and specific laboratory investigations including assessment of glycosylated hemoglobin [HbA1C] for diabetic mothers, and erythrocyte antioxidant enzymes [superoxide dismutase, catalase and glutathione peroxidase] and DNA fragmentation assay for mothers and neonates of both groups. It was found that 25% of the diabetic women had diabetic complications. About 1/3 of the newborn infants of diabetic mothers were large for gestational age, 10% of them had major congenital anomalies [cyanotic heart disease and meningomyelocele] and 15% of them died. Levels of erythrocytes glutathione peroxidase and catalase were significantly lower in diabetic mothers and their infants than those in nondiabetic mothers and their infants. DNA damage, mainly in the form of apoptosis was present in diabetic mothers and their infants [60% and 50% respectively]. There was a significant difference between the values of maximal optical density at 200bp and 600bp between both groups. Comparison between diabetic mothers with and without diabetic complications as regards HbA1C, antioxidants and DNA damage showed that erythrocytes catalase was significantly lower in those with complications [means 366 +/- 54 units/g Hb, 426.3 +/- 45.7 units/g Hb respectively] as a possible explanation for complications in this group. There was a significant negative correlation between HbA1C of diabetic mothers [i.e. diabetic control] and glutathione peroxidase level [i.e. antioxidant defense] in their infants. A significant negative correlation was found between DNA damage and erythrocytes antioxidant [Superoxide dismutase in diabetic mothers, and glutathione peroxidase in their infants]. It can be concluded that hyperglycemia causes a significant reduction of antioxidant capacity [reduced catalase and glutathione peroxidase] in the diabetic mothers and their infants compared with controls and this may be the cause of increased DNA damage observed in these individuals which may lead to the development of diabetic complications in the pregnant mothers and congenital anomalies in their infants. It is recommended to maintain a good control of diabetes and combat oxidative stress to lessen diabetic complications in pregnancy and to avoid congenital anomalies