Oxidative stress in maternal milk and cord blood in gestational diabetes mellitus: a prospective study

ABSTRACT BACKGROUND: Reduced antioxidant defenses may reflect a poor protective response against oxidative stress and this may be implicated in progression of gestational diabetes mellitus (GDM). Oxidative stress induced by hyperglycemia plays a major role in micro and macrovascular complications, which imply endothelial dysfunction. OBJECTIVE: Our aim in this study was to investigate the association between GDM and oxidative stress markers measured in plasma, with regard to revealing changes to total antioxidant capacity (TAC) and total oxidant status (TOS) among mothers showing impairments in oral glucose tolerance tests (OGTTs). DESIGN AND SETTING: Prospective study at a university hospital in Turkey. METHODS: The study group consisted of 50 mothers with GDM, and 59 healthy mothers served as controls. Umbilical cord blood samples were taken from all mothers during delivery and breast milk samples on the fifth day after delivery. TAC, TOS, thiol and disulfide levels were measured. RESULTS: No statistically significant relationship between the blood and milk samples could be found. An analysis on correlations between TAC, TOS and certain parameters revealed that there were negative correlations between TOS and total thiol (r = -0.386; P < 0.001) and between TOS and disulfide (r = -0.388; P < 0.001) in milk in the control group. However, these findings were not observed in the study group. CONCLUSION: Our findings suggested that a compensatory mechanism of oxidative stress was expected to be present in gestational diabetes mellitus and that this might be ameliorated through good glycemic regulation and antioxidant supplementation.

Predicting neonatal sepsis in ventilated neonates.

OBJECTIVE: To show the value of serial endotracheal aspirate culture in predicting organisms causing sepsis in ventilated neonates. METHODS: We studied 100 newborns in Zeynep Kamil Maternity and Children's Training and Research Hospital Neonatal Intensive Care Unit. Endotracheal aspirate and blood cultures were taken first on the third day and then once a week till extubation. RESULTS: Blood and endotracheal cultures showed the same organism only in 17.6% of the patients. There was no relationship among 86.4% of the patients. The rate of culture positivity increased as the birth weight decreased, gestation week got smaller and the duration of intubation prolonged. CONCLUSION: The antibiotherapy arranged according to the endotracheal aspirate cultures is not suitable for a possible sepsis agent. Moreover, resistant organisms may occur in hospitals if the antibiotics used unnecessarily.