Umbilical Cord Plasma Glutathione S-Transferase Alpha 1-1 Levels as a Marker of Neonatal Hepatocellular Integrity

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 91; no. 4; pp. 490 - 494
• Main Authors: Knapen, Maarten F.C.M, Wong, Wai Yee, Mulder, Theo P.J, Peters, Wilbert H.M, Merkus, Hans M.W.M, Steegers, Eric A.P
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.1998; The American College of Obstetricians and Gynecologists; Elsevier Science
• Subjects: Adolescent; Adult; Biological and medical sciences; Biomarkers - blood; Birth Weight; Delivery, Obstetric; Delivery. Postpartum. Lactation; Female; Fetal Blood - chemistry; Glutathione Transferase - blood; Gynecology. Andrology. Obstetrics; Humans; Infant, Newborn - blood; Linear Models; Liver - physiology; Liver Function Tests; Maternal, fetal and perinatal monitoring; Medical sciences; Smoking; Human; Statistical analysis; Pregnancy disorders; Enzyme; Transferases; Biological marker; Umbilical artery; Blood plasma; Liver function; Fetal diseases; Vaginal route; Mother; Glutathione transferase; Surgery; Fetus; Influence; Fetal distress; Delivery; Umbilical vein; Cesarean section
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1016/S0029-7844(98)00041-6

Objective: To investigate possible delivery-related impaired neonatal hepatocellular integrity by assessment of arterial and venous umbilical cord plasma levels of glutathione S-transferase Alpha 1-1. Methods: Glutathione S-transferase Alpha 1-1 levels were assessed in arterial and venous umbilical cord, and maternal venous plasma samples. The influence of maternal, delivery, and neonatal characteristics on arterial umbilical cord glutathione S-transferase Alpha 1-1 levels was studied, using linear regression analysis after log-transformation. Results: Median (range) arterial umbilical cord glutathione S-transferase Alpha 1-1 plasma levels were higher than venous umbilical cord levels (9.68 [0.64–1125] μg/L and 7.66 [0.78–987.5] μg/L, respectively, P < .005). Median (range) arterial and venous umbilical cord glutathione S-transferase Alpha 1-1 levels were higher than, and did not correlate with, maternal venous plasma levels (8.79 [1.79–183] μg/L and 6.47 [1.58–164.5] μg/L versus 1.47 [0.46–10.4] μg/L, P < .001). Neonates born vaginally demonstrated higher median (range) levels than those delivered by cesarean (13.41 [1.02–1125] μg/L and 5.73 [0.64–172.90] μg/L, respectively, P < .001). Neonates with unfavorable pH (arterial pH under 7.20) demonstrated higher median (range) levels than those with normal pH (arterial pH at least 7.20) (15.15 [0.77–1125] μg/L and 8.82 [0.64–120.90] μg/L, respectively, P < .001). Stepwise multiple linear regression analysis showed that birth weight had the largest influence on arterial umbilical cord glutathione S-transferase Alpha 1-1 levels, followed by arterial base deficit, and route of delivery. Conclusion: Arterial umbilical cord glutathione S-transferase Alpha 1-1 plasma levels, being unrelated to maternal venous levels, might give a reliable impression of early neonatal hepatocellular integrity and may become an additional indicator of neonatal condition immediately after birth.