Effects of antiretroviral agents during pregnancy on liver enzymes and amylase in HIV-exposed, uninfected newborn infants

This study assessed the effect of antiretroviral drugs administered to pregnant women on amylase and liver enzymes of the neonate. A prospective study was conducted on 52 neonates divided into three groups: infants born to HIV-infected mothers taking zidovudine (ZDV group, n = 18), infants born to mothers taking zidovudine + lamivudine + nelfinavir (TT group, n = 22) and infants born to normal women (control group, n = 12). Umbilical cord blood from the newborn infant was used to determine liver transaminases and amylase. Data were analyzed statistically by nonparametric tests, with the level of significance set at p<0.05. The median levels for TT group newborns were 33.3 U/L for oxaloacetic transaminase, 21.5 U/L for pyruvic transaminase, 1.9 mg/dL for total bilirubin, 153 mg/dL for alkaline phosphatase, and 9.6 U/L for amylase. These results did not differ from those obtained for Control newborns or newborns exposed to ZDV alone. No association was observed between the use of antiretroviral drugs during pregnancy and adverse effects on neonatal amylase and hepatic parameters at birth.

Oxidative stress is closely related to clinical severity of pre-eclampsia

Pre-eclampsia is a hypertensive disorder of pregnancy in which enzymatic antioxidant defenses fail and tissues are injured. This prospective case-control study evaluated whether pre-eclamptic women and their newborns show higher degrees of oxidative stress than normal pregnancies and sought to determine if this stress is related to clinical severity. Forty-four pre-eclamptic and thirty healthy pregnant women attending two hospitals in Valparaíso, Chile, were studied. The following plasmatic variables of antioxidant capacity were evaluated: glutathione peroxidase activity (GPx), total antioxidant capacity measured by oxidation of ABTS substrate (2,2'-azino-bis (3-ethylbenzthiazoline-6-sulfonic acid), and superoxide dismutase activity (SOD). malondialdehide (MDA) was measured to evaluate lipoperoxidation. The evaluation was performed at diagnosis of pre-eclampsia, delivery, 30 days and 120 days post delivery. Newborns were studied at delivery through umbilical cord blood samples. Our analysis shows that antioxidant enzyme activity (SOD, GPx, ABTS) was significantly decreased, while lipoperoxidation (MDA) was increased in both pre-eclamptic groups compared to normal pregnant women (p<0.01). Statistically significant difference was found between mild and severe pre-eclamptic groups (p<0.01), for all biochemical markers studied. Therefore, the clinical severity of this pathology is closely related to the degree of oxidative stress.

The value of methemoglobin reduction test as a screening test for neonatal glucose 6-phosphate dehydrogenase deficiency.

Glucose 6-phosphate dehydrogenase (G-6-PD) deficiency is common in the Thai population and is the cause of neonatal hyperbilirubinemia and hemolytic anemia. This X-linked disorder is much more common in males than females. The objectives of this study were to compare the result of the screening methemoglobin reduction test (MRT) with the gold standard G-6-PD activity, and also to determine the prevalence of G-6-PD deficiency in the cord blood and blood of neonates with hyperbilirubinemia. Five hunderd and twenty two randomly selected cord blood (350 males, 172 females) and 229 peripheral blood from neonates with hyperbilirubinemia were assayed for G-6-PD enzyme activity using a WHO-recommended standard test as well as methemoglobin reduction (MR) test. The results showed that prevalence of G-6-PD deficiency from the cord blood was 11.1 per cent in males, and 5.59 per cent in females. Among newborns with neonatal jaundice, the prevalence of G-6-PD deficiency was 22.1 per cent in males and 10.1 per cent in females. MRT in cord blood G-6-PD deficiency screening had acceptable sensitivity (85.7%) and high specificity (98.1%). The sensitivity of MRT in jaundiced infants was low (60.0%) whereas the specificity was acceptable (92.1%). The negative predictive values were more than 90 per cent while the positive predictive values were low (61-65%) from both specimens. Conclusions: G-6-PD deficiency is common in the Thai population, both in males and females and can be screened from cord blood by using low cost MRT. G-6-PD deficiency contributes to 20 per cent of neonatal jaundice, and screening with MRT yields low sensitivity.

Adenosine deaminase in cord blood as an immunoenzyme marker in low birth weight neonates.

Adenosine Deaminase (ADA) levels were estimated in cord blood of 30 neonates born with birth weight less than or equal to 2.5 kg and 30 neonates born with birth weight greater than 2.5 kg. The mean ADA levels in low birth weight (LBW) group was found to be 6.94 U/L and in normal birth weight group the mean ADA levels were 14.37 U/L which was statistically significant. Therefore ADA may be useful in assessing CMI status in low birth weight infants.

Aspectos clínicos e laboratoriais da deficiência de desidrogenase de 6-fosfato de glicose (G-6-PD) em recém nascidos brasileiros / Clinical and laboratory aspects of glucose-6-phosphate dehydrogenase (G-6-PD) deficiency in Brasilian newborns

Os estudos relativos à deficiência de desidrogenase de 6-fosfato de glicose (G-6-PD) e à icterícia neonatal säo raros e controvertidos no Brasil. No presente estudo alguns aspectos clínicos e laboratoriais da deficiencia de G-6-PD foram investigados em uma amostra de 25 pacientes triados dentre 697 recém-nascidos da regiäo de Campinas, SP. A deficiência foi investigada em amostras de sangue do cordäo umbilical por intermédio de testes de triagem (testes de reduçäo da metemogloblina e teste de descoramento do azul cresil brilhante) e confirmada pelo ensaio enzimático quantitativo e plea electroforese de G-6-PD em gel de amido. Vinte e quatro recém-nascidos apresentaram a variante Africana ou A de G-6-PD, mais branda, e apenas um apresentou a variante Mediterrânea, mais grave. A incidência da icterícia moderada foi maior entre os recém-nascidos deficientes de G-6-PD, embora as crianças näo tenham sido expostas a agentes potencialmente hemolsiticos do meio ambiente. Embora resultados falsamente positivos possam ser obtidos pelo teste de reduçäo da metemoglobina, ele pode ser usado como um teste de triagem simples e muito econômico, desde que os resultados positivos sejam confirmados posteriormente pelo teste de descoramento do azul cresil brilhante e/ou pelo ensaio enzimático quantiitativo

Deficiencia de deshidrogenasa de la glucosa -6- fosfato (G6PD) en varones neonatos en Monterrey, Nuevo León / Glucose -6- phosphate de hydrogenase (G6PD) defficiency in males newborn infants in Monterrey, Nuevo León

Con el propósito de conocer la frecuencia de deficiencia de la enzima deshidrogenosa de la glucosa-6-fosfato (G6PD) eritrocítica en la población del área metropolitana de Monterrey, N. L., se estudiaron 752 neonatos varones que se selecionaron al azar de partos normales. A cada sujeto de estudio se le tomó sangre de cordón umbilical, en tubo heparinizado, la cual se sometió a la prueba cualitativa de Beutler. De los resultados obtenidos se encontraron cinco individuos deficientes, lo que corresponde a una frecuencia de 0.66 por ciento, que es muy similar a la informada para otras poblaciones mestizas e indígenas mexicanas en las que se ha pensado sobre un origen africano del gen causante de la deficiencia. Como ésta es la más común de las deficiencias enzimáticas del eritrocito, se sugiere la conveniencia de incluirla dentro de las prubas cualitativas de investigación metabólica en el recién nacido, principalmente en los considerados de alto riesgo para prevenir en ellos las crisis hemolíticas por exposición a ciertos medicamentos o alimentos