Abstract

Introduction. In modern obstetrics, there are a significant number of diagnostic methods to detect fetal distress, including intrapartum. At the same time, the mechanisms of fetal adaptation to various stressors remain poorly understood. The aim of our study was to provide a clinical assessment of brain and glial neurotrophic factors (NTF) in umbilical cord blood when the fetus is exposed to stressors. Materials and methods. The study included 96 cases, which were divided into five groups depending on the data of retrospective analysis of the history of childbirth, the condition of the newborn. After delivery samples were taken, the level of BDNF (brain-derived neurotrophic factor), GDNF (glial cell-derived neurotrophic factor). Results. The mean NTF level of BDNF in group 1 was 970.3 (60.9) ng/mL, in group 2 was 1499.8 (72.12) ng/mL, in group 3 was 1243.5 (67.49) ng/mL, in group 4 was 1245.5(80.8) ng/mL, in group 5 was 573.5(43.9) ng/mL (p<0.001). Mean GDNF NTF level in group 1 was 35 pg/mL, in group 2 was 41.3 pg/mL, in group 3 was 311.00 pg/mL, in group 4 was 80.00 pg/mL, and in group 5 was 35.6 pg/mL, (p><0.001). The incidence of fetal functional impairment in labor was not established in group 1, group 2 was 18.8%, group 3 was 29.2%, group 4 was 35.3%, and group 5 was 77.8% (p=0.001). The incidence of impaired fetal functional status in labor was not established in groups 1 and 2, in group 3, 4.2%, in group 4, 17.6%, and in group 5, 77.8% (p><0.001). Discussion. Clinical study data indicate the existence of a close relationship between the level of neurotrophic factors and the realization of fetal compensatory-adaptive capabilities in the presence of fetal hypoxia development factors in labor. Conclusion. The participation of BDNF and GDNF molecules in the regulation of fetal homeostasis under intrapartum exposure to stressors has been established. High levels of BDNF and GDNF provide fetal protection as part of an endogenous system of compensatory mechanisms in the regulation of fetal homeostasis.><0.001). Mean GDNF NTF level in group 1 was 35 pg/mL, in group 2 was 41.3 pg/mL, in group 3 was 311.00 pg/mL, in group 4 was 80.00 pg/mL, and in group 5 was 35.6 pg/mL, (p<0.001). The incidence of fetal functional impairment in labor was not established in group 1, group 2 was 18.8%, group 3 was 29.2%, group 4 was 35.3%, and group 5 was 77.8% (p=0.001). The incidence of impaired fetal functional status in labor was not established in groups 1 and 2, in group 3, 4.2%, in group 4, 17.6%, and in group 5, 77.8% (p><0.001). Discussion. Clinical study data indicate the existence of a close relationship between the level of neurotrophic factors and the realization of fetal compensatory-adaptive capabilities in the presence of fetal hypoxia development factors in labor. Conclusion. The participation of BDNF and GDNF molecules in the regulation of fetal homeostasis under intrapartum exposure to stressors has been established. High levels of BDNF and GDNF provide fetal protection as part of an endogenous system of compensatory mechanisms in the regulation of fetal homeostasis.><0.001). The incidence of fetal functional impairment in labor was not established in group 1, group 2 was 18.8%, group 3 was 29.2%, group 4 was 35.3%, and group 5 was 77.8% (p=0.001). The incidence of impaired fetal functional status in labor was not established in groups 1 and 2, in group 3, 4.2%, in group 4, 17.6%, and in group 5, 77.8% (p<0.001). Discussion. Clinical study data indicate the existence of a close relationship between the level of neurotrophic factors and the realization of fetal compensatory-adaptive capabilities in the presence of fetal hypoxia development factors in labor. Conclusion. The participation of BDNF and GDNF molecules in the regulation of fetal homeostasis under intrapartum exposure to stressors has been established. High levels of BDNF and GDNF provide fetal protection as part of an endogenous system of compensatory mechanisms in the regulation of fetal homeostasis.><0.001). Discussion. Clinical study data indicate the existence of a close relationship between the level of neurotrophic factors and the realization of fetal compensatory-adaptive capabilities in the presence of fetal hypoxia development factors in labor. Conclusion. The participation of BDNF and GDNF molecules in the regulation of fetal homeostasis under intrapartum exposure to stressors has been established. High levels of BDNF and GDNF provide fetal protection as part of an endogenous system of compensatory mechanisms in the regulation of fetal homeostasis.

Highlights

  • In modern obstetrics, there are a significant number of diagnostic methods to detect fetal distress, including intrapartum

  • The aim of our study was to provide a clinical assessment of brain and glial neurotrophic factors (NTF) in umbilical cord blood when the fetus is exposed to stressors

  • The incidence of fetal functional impairment in labor was not established in group 1, group 2 was 18.8%, group 3 was 29.2%, group 4 was 35.3%, and group 5 was 77.8% (p=0.001)

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Summary

Introduction

There are a significant number of diagnostic methods to detect fetal distress, including intrapartum. Однако несмотря на наличие нескольких факторов развития гипоксии плода в родах исход родов в 70,8% случаев был для плода благоприятный: оценка по Апгар при рождении — 8/9 баллов (на 1 и 5-й минутах жизни новорожденного) и благополучное течение периода адаптации. В этой группе анамнестически отсутствовали факторы риска развития гипоксии, и в 100% случаев исход родов для плода был благоприятным, что позволяет нам отнести полученные значения факторов BDNF и GDNF к базальным. В группе наименьшего риска развития гипоксии плода в родах (группа 1), где уровень GDNF и BDNF был принят за базальный, риск нарушения функционального состояния плода в родах и риск развития асфиксии не был установлен (рис.). В группе низкого риска развития гипоксии плода в родах (группа 2) наблюдали изолированное умеренное увеличение уровня BDNF, при этом риск развития асфиксии не установлен, однако выявлен риск нарушения функционального состояния плода, который наблюдали в 6 (18,8%) случаях (рис.).

Сравнение уровня BDNF в зависимости от принадлежности к
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Патологический тип КТГ
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