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Objectives: The aim of the study was to analyze the levels of pro-inflammatory interleukins in cervical secretions of women with PROM, depending on Ureaplasma spp. infection and the time elapsed since the rupture of the membranes, and to correlate their concentration in cervical secretions and in cord blood of the newborns., Material and Methods: The study included 30 women with PROM between 24 and 33+6 weeks of gestation. Cervical swabs from women with confirmed rupture of membranes taken at certain intervals and umbilical cord blood of their newborns constituted the study material. Cervical secretions were evaluated microbiologically and by the PCR method. Concentrations of IL-6, IL-19, IL-10 and TNF-α were analyzed by ELISA., Results: Ureaplasma spp. were the most frequently isolated microorganisms in cervical secretions of women with PROM. Secretion of interleukins in the cervix was not influenced by time elapsed since the PROM. Comparison of interleukin levels in cord blood of newborns born to mothers with and without Ureaplasma spp infection revealed significantly higher levels of IL-6 in the case of Ureaplasma spp. A positive correlation between IL-6 and TNF-α levels in cervical secretions and in cord blood of mothers with PROM and Ureaplasma spp. was detected., Conclusions: 1. Cervical culture method appears to be sufficient for detecting Ureaplasma spp. 2. Pro-inflammatory interleukins, especially IL-6, obtained by non-invasive methods can be used to predict fetal inflammatory response.

Anemia during pregnancy is a risk factor of disturbance in pre- and postnatal child's development. Hepcidin plays the key role in iron metabolism, as protein participating in the regulation of intestinal absorption of this element and its release from macrophages, and transport across the placenta. Maternal smoking during pregnancy can result in disturbances of iron homeostasis leading to a subclinical deficiency. The depletion of maternal iron can cause fetal hypoxia condition and decreased expression of hepcidin. The aim of the study was to evaluate the effect of smoking on the levels of hepcidin and erythropoietin (as an indicator of hypoxia) and their relationships in umbilical cord blood. The research material was the umbilical cord blood of 50 newborns born in the Department of Obstetrics and Gynecology (Institute of Mother and Child in Warsaw) in the years 2013-2014. Based on an interview and determination of cotinine in the blood of mothers, newborns were divided into following groups: children of smoking mothers (n=20) and children of tobacco abstinent mothers (n=30). Hepcidin and erythropoietin concentrations were determined by enzyme immunoassay using commercial kits (DRG, Germany). It has been shown that hepcidin concentrations were significantly lower in children of smoking mothers than in the group of tobacco abstinent (37.5 ng/mL vs 45.1 ng/mL, p<0.001). However, the level of erythropoietin was higher in children of smoking mothers than in children of non-smoking women (p<0.001). A negative correlation between the levels of hepcidin and erythropoietin (r = -0.41, p<0.05) and number of smoked cigarettes (r = -0.43, p<0.05) was observed. These results indicate that smoking during pregnancy significantly affects hepcidin levels in children born at term. Decrease of hepcidin concentration coexisting with high level of erythropoletin in umbilical cord blood in children of smoking pregnant women may be the cause of subclinical deficiency of iron in the newborn.

NIFTY (Non-invasive Fetal Trisomy Test) is a non-invasive prenatal test which is used for diagnosing fetal trisomy. The test is based on the analysis of cell free fetal DNA (cffDNA) present in the plasma and serum of a pregnant woman. NIFTY allows to detect fetal trisomy of chromosomes 13, 18, 21, X and Y and also X monosomy. Abnormal NIFTY results still need to be verified using other diagnostic techniques. However the sensitivity of NIFTY for trisomy 21, 18 and 13 is estimated at 99%, 97% and 79% respectively with false positive rate for all examined trisomies and X monosomy of < 1%. NIFTY is currently available in Poland as a commercial service, used as a good screening test for common trisomies (apart from ultrasound and biochemical tests) in the case of patient anxiety and in situation when the patient does not consent to invasive prenatal diagnostic tests. The sensitivity and specificity of NIFTY will most likely be improved as laboratory methods develop, and after a sufficiently large group of pregnant patients has been tested. Therefore, this test may soon become the primary diagnostic tool for common trisomies, allowing to avoid invasive prenatal testing in this indication. With high probability cffDNA obtained from the serum of pregnant women will also be used with time in the diagnosis of fetal structural chromosomal aberrations and other genetic changes. The aim of our study is to present a new diagnostic method.

Objectives: The aim of the study was to present initial results of non-invasive prenatal diagnosis of common aneuploidies of chromosomes 21, 18 and 13 based on cell-free fetal DNA in maternal serum in high-risk patients, and to compare the results with routine karyotyping., Material and Methods: Before the invasive procedure, 10 ml of peripheral blood from 10 patients was collected to isolate cell-free fetal DNA and to perform a non-invasive fetal trisomy test (NIFTY provided by Beijing Genomics Institute, BGI, Shenzen, China)., Results: Three out of 10 samples showed an abnormal karyotype in traditional karyotyping. There were 9 conclusive NIFTY results. NIFTY detected 1 out of 2 trisomies 18. The quantity of cell-free fetal DNA in maternal plasma in the second probe with trisomy 18 was unsatisfactory fora conclusive NIFTY result. In 1 case traditional karyotyping revealed mosaicism impossible to detect with NIFTY

Aim: The study aimed to compare the concentrations of triglycerides, total cholesterol and its fractions and apolipoproteins in cord blood serum in newborns and in blood serum in older children. The influence of gender, intrauterine development, nutritional status and diet on lipid parameters was also assessed., Material and Methods: The longitudinal study was performed in three stages. During stage I the tests were carried out in 137 newborns after birth. Stage II of the study included 41 children aged 18-30 months, and stage III covered 47 children aged 5-6 years. Due to the long-term and multi-stage study, in the evaluation of the results, only 41 children were included; they were only the ones who participated in all three stages, and the test results of whom were complete. In newborns, the gestational age and the birth weight were evaluated. In the older children, the nutritional status was rated by measuring the Body Mass Index and the skin folds thickness as well as the nutrition from birth was assessed. In all of the studied children the concentration of triglycerides, total cholesterol and its fractions: HDL, LDL and VLDL cholesterol and apolipoproteins (AI and B) were measured., Results: The concentrations of lipids, lipoproteins and apolipoproteins in serum increase during the first years of children's life as compared with the values of cord blood serum (p<0.001). Differences in the concentration of lipids and lipoproteins in cord blood serum in the newborns were noticed with relation to gender and birth weight. No fundamental statistical differences were shown between the studied parameters in older children with relation to the gender, nutritional status and the method of feeding after the birth., Conclusion: Based on the long-term studies in this group of children, one may conclude that the gender and birth weight have the largest effect on the lipid parameters in the cord blood. However, the gender, the nutritional status and the method of feeding after birth were not related with lipid metabolism. It seems advisable to continue further studies in the same group of children in order to assess the impact of environmental factors on selected parameters of lipid metabolism.

Epilepsy is one of the most common neurological diseases in the world. One of the most difficult clinical problems associated with the disease is to treat pregnant women because the use of antiepileptic drugs increase the risk of birth defects in the fetus. The second most common use in pregnant women is an antiepileptic drug valproic acid. Its use is associated with an increased risk of serious birth defects such as neural tube defects, heart defects, cleft palate, urinary tract defects, limb defects, specific syndromes that cause dysmorfizm face or abnormalities of the reproductive organs and developmental disorders affecting cognitive and behavioral functions. To minimize the risk to the fetus can be through the use of contraception and planning for pregnancy, taking valproic acid monotherapy, at a dose of less than 1000 mg/day in 2-3 divided doses, folic acid supplementation, close monitoring during pregnancy and full cooperation with doctors: a gynecologist and neurologist. The aim of this study was to measure the concentrations of valproic acid in maternal serum and cord serum and a reference to the results of the newborn. The concentrations of valproic acid in the serum was performed using high performance liquid chromatography method with fluorometric detection. Valproic acid concentration in the blood serum of patients housed or slightly exceed the therapeutic concentration. In all samples of umbilical cord blood serum were detected, no drug found to have birth defects. Born children should remain under control in order to detect possible birth defects that cannot be detected immediately after birth.

The objective of this study was to evaluate the effect of cigarette smoking on concentration of selected angiogenic factors (vascular endothelial growth factor VEGF, placenta growth factor PIGF) and somatomedin C (insulin-like growth factor-I) in blood of mothers and umbilical cord blood. The correlations between studied biochemical parameters and markers of estimated intensity of cigarette smoking as well as birth weight were also determined. Fifty healthy pregnant women were divided into two groups: smoking and tobacco abstinent group according to serum cotinine concentration. The current smokers were defined as those who had smoked 5 cigarettes per day for 2 years before conception and continued smoking during pregnancy. In the group of smoking mothers the mean serum concentration of cotinine was 91.6 microg/L and correlated positively with number of cigarettes daily consumed (r = 0.58, p < 0.01) as well as with time of smoking before conception (r = 0.40, p < 0.05). The mean serum concentration of PIGF in III trimester of pregnancy was significantly higher in the group of smokers than in non-smoking ones (p < 0.0001) and correlated with serum cotinine concentration (r = 0.41, p < 0.05) and number of cigarettes daily consumed (r = 0.58, p < 0.01). The concentration of serum VEGF was similar in both studied group. The mean serum level of IGF-I was significantly lower in group of smokers than in non-smokers in the I and III trimester of gestation (p < 0.01). Also in umbilical cord blood of smoking newborn the concentration of IGF-I was lower by 20% than in nonsmoking group (p < 0.05). We observed negative correlation between number of cigarettes daily consumed and serum level of IGF-I in blood of mothers as well as in blood of their children (I trimester: r = -0.43, p < 0.05; III trimester: r = -0.70, p < 0.001; umbilical cord blood: r = -0.45, p < 0.05). In both studied groups there were a positive correlation between birth weight and concentrations of IGF-I in blood of mothers and umbilical cord blood (group of smokers: mothers r = 0.43, p < 0.05, cord blood r = 0.50, p < 0.01; group of tobacco abstinent: mothers r = 0.51, p < 0.01, cord blood r = 0.41, p < 0.05). The birth weight of the smoking mothers' infants was lower by about 400 g (p < 0.01) and their birth body length by 1.5 cm (p < 0.05) and negatively correlated with number of cigarettes smoked per day (r = -0.55; p < 0.005). Our results indicate, that tobacco smoking during pregnancy increased serum PIGF levels in the final stages of gestation and has no effect on the concentration of VEGF, which may lead to an increase of trophoblast proliferation and uteroplacental dysfunction. Lower than in tobacco abstinent levels of IGF-I in serum of smoking mothers and in umbilical cord blood and their close relationship with birth weight, may suggests a direct effect of this factor on birth anthropometric parameters.

Objective: To determine the relationship between cord blood cotinine levels and some markers of perinatal hypoxia such as cord blood erythropoietin levels, parameters of umbilical arterial blood gas analysis and Apgar scores., Methods: 150 women with uncomplicated, healthy singleton pregnancies were assessed by means of a patient questionnaire. Neonates born by the examined pregnant women were divided into 3 groups according to recorded maternal smoking status--active smoking: n = 51, passive smoking: n = 49, non smoking: n = 50. Immediately after birth umbilical venous (for cotinine and erythropoietin levels) and arterial blood (for pH, pO2, pCO2, BE) were collected., Results: Cotinine levels were significantly higher (p < 0.00001) in active smoking group (Me = 19.3 ng/ml) than in passive smoking (Me = 0.75 ng/ml) and non smoking (Me = 0.72 ng/ml) ones. Cord blood erythropoietin, pH values and 1, 3 and 5-minute Apgar scores did not differ significantly between the study groups. No significant correlation between cotinine and erythropoietin, pH and Apgar scores results in all study material and in the compared groups was found., Conclusion: No correlation between cord blood cotinine and erythropoietin levels was detected. Cord blood cotinine concentration does not influence the condition of the newborn assessed by Apgar scores and umbilical arterial blood gas analysis.

Objectives: Noninvasive fetal RHD genotyping from maternal plasma of RhD(/-) pregnant women of Caucasian race may be used for predicting the risk of hemolytic disease because the RHD gene is usually absent in such populations. If detected in plasma of such women, the RHD gene originates from the RhD(+) fetus. The number of fetal copies of the gene in maternal plasma is extremely small. In the presented case of the RhD(/-) pregnant woman with anti-D it was impossible to give a fetal RHD result due to mother's RHD(+) genotype. The fetal RHD was determined from amniocytes., Aim: to present the difficulties related to the interpretation of results of invasive and noninvasive procedures., Material and Methods: whole blood, plasma and amniotic fluid of the RhD(-) woman with anti-D (14 week of pregnancy) as well as whole blood of the newborn. RHD and RHCE*c were genotyped by real-time PCR in DNA isolated from maternal plasma and amniocytes and the RHD and d-genotypes were tested by SSP methods in DNA isolated from whole blood and amniocytes., Results: RHD and RHCE*c were detected in DNA isolated from plasma. The high level of RHD suggested its origin from the mother's DNA therefore it was impossible to determine the fetal RHD. The d-little test identified a RHD(IVS3+ 1G>A) variant in the mother's genome. A weak signal of real-time PCR for the RHD was obtained in amniocytes but the RHD was not detected by SSP. The RHCE*c was detected by both methods. Results were inconclusive; the fetal RHD status remained unknown. The child was RhD(-) with RHD in its DNA undetected by either method., Conclusions: 1/The RHD(IVS3+ 1G>A) variant in the RhD(-) mother precluded formal noninvasive fetal RHD genotyping. 2/Real-time PCR is too sensitive for amniocyte testing and may lead to false results as it detects trace maternal DNA in amniotic fluid. 3/The frequency of RHD(IVS3+1G>A) occurrence in Poland requires further studies.

Aim: Resistin is believed to play a certain role in the pathogenesis of gestational diabetes mellitus (GDM). The aim of the study was to assess resistin concentrations in women with diet-treated GDM and good glycemic control, in healthy pregnant women and in cord blood, depending on the advancement of the pregnancy, maternal body mass index (BMI) and index of insulin resistance (HOMA-IR), as well as on somatic features of the newborns., Materials and Methods: The study group consisted of 20 women with GDM whereas 20 healthy women constituting the control group. They were examined twice: at 23-32 weeks and at 35-37 weeks of gestation. Serum resistin concentration was assessed using RIA method., Results: In the control group, maternal resistin concentration was higher (p<0.03) after the second examination than the first one. In the GDM group, maternal resistin concentration was similar to that in the control group in both examinations. No correlations were found either between maternal resistin and insulin concentrations or between maternal resistin concentration and BMI or HOMA-IR. No correlations were found between maternal resistin concentration or cord blood resistin concentration and somatic features of newborns, either. In both groups, resistin concentration in cord blood was higher than in maternal blood during both examinations., Conclusions: Our results indicate that maternal resistin concentration increases as pregnancy advances. In women with diet-treated GDM and good glycemic control resistin concentration is similar to that observed in healthy pregnant women. No relationship was found between resistin concentration in cord blood and somatic features of the newborns.

Objectives: The aim of the study was to detect the presence of pro-hepcidin in the serum of pregnant women and in umbilical cord blood. Additionally, correlations between pro-hepcidin and other iron parameters were analyzed., Material and Methods: Our study consisted of 32 healthy, pregnant women, patients of Clinical Department of Obstetrics and Gynaecology, Institute of Mother and Child (IMC). Serum concentrations of pro-hepcidin were determined with the use of immunoenzymathic method, levels of ferritin and transferrin with immunoturbidimetric method and iron with photometric test. Hemoglobin and hematocrite were determined on hematological analyzer Pentra 60. The study was conducted at the Department of Biochemistry IMC., Results: The mean concentration of pro-hepcidin in the serum of pregnant women was 102.0+/-30.7 ng/ml and ranged from 51.5 to 187.1 ng/ml. Level of pro-hepcidin in the serum of the umbilical cord blood was 77.05+/-21.2 ng/ml (range: 41.9-125.9 ng/ml), which amounted up to about 75% of that found in mothers, thus making the differences were statistically significant (p<0.01). We observed a positive correlation between concentrations of that prohormone in the serum of mothers and cord blood (r=0.60; p<0.01). Our analysis revealed no correlations between the serum pro-hepcidin levels and other studied parameters of iron status, both in the mothers and children groups., Conclusions: Our results indicate that concentrations of pro-hepcidin are detectable in the serum of mothers, as well as in the umbilical cord blood, and positively correlate with each other. No anemia or subclinical iron deficiency that could explain no correlation with others parameters of iron status was observed.

Iron deficiency relatively observed in pregnant women is assumed to be enhanced by cigarette smoking. Hepcidin, a peptide hormone produced by the liver as pro-hepcidin, has recently emerged as a central mediator of iron metabolism. Hepcidin regulates intestinal iron absorption, macrophage iron release, and the placental passage of iron. Maternal smoking is associated with increased fetal iron requirements and stimulates fetal erythropoiesis. This is probably through a hypoxic effect on the fetus, and is dose related to the maternal smoking level. It is known that anemia and hypoxia suppress hepcidine mRNA expression. Therefore the aim of the study was to estimate the effect of tobacco smoking on serum pro-hepcidin levels and some iron parameters in pregnant women and umbilical cord blood. We also studied correlation between pro-hepcidin and others iron markers in mothers and their newborns. Healthy, pregnant women (n = 50), patients of Clinical Department of Obstetrics and Gynecology, Institute of Mother and Child were divided into groups nonsmoking and smoking according to questionnaire declaration. Serum concentrations of pro-hepcidin were determined by immunoenzymathic method using a commercial pro-hepcidin assay (DRG, Germany). Levels of ferritin and transferrin were measured by immunoturbidimetric method and iron by photometric test with ferrozine using HORIBA ABX kits (France) and Cobas Mira analyser (Roche, Switzerland). Levels of hemoglobin and hematocrite were determined using commercially available kits on Pentra 60 analyser (ABX, France). We observed that the mean concentration of pro-hepcidin in serum of smoking pregnant women was statistically lower than in tobacco abstinent (101.9 +/- 28.6 ng/ml vs 88.3 +/- 18.2 ng/ml; p < 0.01). Levels of others studied iron markers were similar in both group except total iron concentration, which was 20% lower in smoking mothers than in nonsmoking ones. In umbilical cord blood of infants born to smoking women level of pro-hepcidin was significantly lower than in tobacco abstinent (54.2 +/- 14.0 ng/ml vs 76.8 +/- 21.4 ng/ml, p < 0.0001). We observed positive correlation between concentrations of that prohormone in serum of mothers and cord blood of their newborns in nonsmoking group (r = 0.54; p < 0.02) as well as in smoking ones (r = 0.68; p < 0.05). In addition, concentrations of ferritin, transferin and total iron were lower by 30%, 13% and 20% respectively in cord blood of smoking than nonsmoking group. The differences were statistically significant (p < 0.05). Our analysis revealed no correlation between serum pro-hepcidin levels and other studied parameters of iron status both in the mothers and children groups. Our results indicate that tobacco smoking during pregnancy affected pro-hepcidine levels in serum of mothers and their newborns. Low concentrations of some iron markers in umbilical cord blood suggest that mother's smoking could lead to subclinical iron deficiency in fetus. No anemia were observed in both studied groups of mothers that could explain no relationships between pro-hepcidin and others parameters of iron status.

Unlabelled: Cystatin C--a low molecular protein, recognized as a sensitive marker of glomerular filtration rate and inhibitor of the lisosomal proteolitic enzymes in the organism. It is produced continuously and released to biological fluids. The concentration of cystatin C in the cord blood is higher and more diverse than in the peripheral blood with children and adults., The Aim of This Study: To determinate the range of the concentrations cystatin C in the umbilical cord blood and to research the influence of delivery and perinatal risk factors on concentration of cystatin C in cord blood., Material and Methods: The study included 444 newborns born by spontaneous deliveries and cesarean sections. In both subgroups, term neonates, preterm and some amount of newborns with additional perinatal risk factors (hipotrofia, infection, asphyxia) were found. Clinical evaluation, blood tests and USG examination were performed. Blood cord samples were analyzed entirely in the neonates with normal USG image of urinary tract was normal., Results: The mean cystatine C concentration in umbilical cord blood were 1.65 +/- 0.44 mg/l. There were not differences in the mean cystatin C concentration between term and preterm newborns without additional risk factors. The most important factor influencing cystatin C concentration appeared to be the kind of delivery In neonates born by spontaneous delivery mean cystatin C concentration was significantly higher (1.82 mg/l) than in neonates born by cesarean sections (1.48 mg/l). Mean cystatin C concentration was strongly correlated with a lactic acid concentration and a length of delivery., Conclusions: Statistically higher concentrations of cystatine C were found in neonates born by spontaneous delivery. Laktacidemia is probably one of the factors responsible for elevation of cystatin C concentration in the cord blood. Higher cystatine C level can be recognized as a mechanism protecting the neonate from local or/and systemic proteolytic activity.

Intensity of oxidative stress caused by prooxidant-antioxidant imbalance may have a pathophysiological effect in fetus of women smoking during pregnancy. Uric acid is the main contributor (60%) to TRAP (total radical trapping antioxidant parameters) which is markers of the plasma total antioxidants capacity. Therefore the aim of the study was to estimate the effect of tobacco smoking on concentration of uric acid in blood of pregnant women and in umbilical cord blood. Correlations between uric acid and total plasma antioxidant capacity in mothers and their babies were also studied. Healthy, pregnant women (n=147) were divided into groups non-smoking and smoking according to questionnaire declaration and concentration of cotinine in serum and urine. Concentration of uric acid in plasma was measured by enzymatic method using available kits from bioMERIEUX (France). We observed that, in both of studied group plasma concentration of uric acid increased during pregnancy. In group of smoking women level of uric acid was lower by 20% in I, by 25% in II and by 15% in III trimester than in group of tobacco abstinent. The differences were statistically significant, although the range concentrations in individual patients in both studied groups were similar (from 102.0 micromol/l to 408.0 micromol/l). In umbilical cord blood of children of smoking mothers mean level of uric acid was lover by 18% than in control group. Plasma concentration of uric acid was significantly correlated with total plasma antioxidant capacity both in smoking (r=0.75; p<0.001) and tobacco abstinent (r=0.60; p<0.05) pregnant women. The similar correlation was observed in umbilical cord blood in both groups (smoking: r=0.74; p<0.001, non-smoking: r=0.60; p<0.05). Reduced concentration of uric acid in plasma of women smoking tobacco during pregnancy suggest, that utilization of this antioxidant for neutralization of free radical present in cigarette smoking is enhanced and may have a negative effect on total plasma antioxidant capacity in mothers and their babies.

In metabolism of homocysteine several enzymes and vitamin cofactors are involves. Genetic abnormalities in these enzymes or nutritional deficiency vitamins, especially of folate may lead to hyperhomocysteinemia, a known risk factor for some pregnancy complications. High maternal homocysteine and low folate levels correlate with low birth weight. Maternal smoking affected significantly total homocysteine concentration in infants. Studies in this area are still scarce and report on limited number of patients. The aim of our study was to assess serum folate and total homocysteine (tHcy) concentrations in smoking pregnant women and in their newborn infants as compared with nonsmoking. The study consisted of 57 pregnant women, who qualified into two groups: smoking (n=28) and nonsmoking (n=29). The serum concentrations of folate were determined by electrochemiluninescent method and tHcy by fluorescence polarization immunoassay. We shown, that serum homocysteine concentrations were significantly higher in smoking as compared with nonsmoking pregnant women (p<0.05) as well as in umbilical cord blood of their newborns (p<0.001). The folate levels were comparable in serum both groups of mothers, but in infants born to smoking women were lower by 20%. In addition, the maternal serum levels of homocysteine and folate showed a significant positive correlation's with these parameters in newborns. Average birth weight infants born to smoking mother was significantly lower than nonsmoking cigarettes (p<0.05). It seems that tobacco smoking during pregnancy affected folate and homocysteine levels in serum of mothers and their infants. Smoking exposure is also associate with reduced birth weight.

Unlabelled: THE AIM of the study was an evaluation of the relationship between histological chorioamnionitis and cord blood soluble intercellular adhesion molecule-1 (sICAM-1) and CRP levels., Material and Methods: in the group of 152 neonates observed for early onset infection (clinical and laboratory signs) the relationship between histological chorioamnionitis and cord blood sICAM-1 (ELISA) and CRP (turbidimetric method) levels was assessed. All these newborns were born in the years 2002-2004 to mothers with risk factors of perinatal infection., Results: histological chorioamnionitis (ChA) was found in 50 cases, while early onset infection signs occurred in 112 neonates. The percentage of ill and healthy newborns in group with ChA and without ChA was similar. There were significantly higher sICAM-1 (p<0.001) levels in neonates from pregnancy complicated with ChA than without ChA (179 +/- 68.7 v. 147 +/- 30.8 ng/ml). There was not such difference in the CRP levels. There was also a significant positive correlation between cord blood sICAM-1 and ChA in the whole analyzed group of patients (r=0.26; p<0.001) and in the group of ill neonates (r=0.37; p<0.0001). There was a significant difference (p<0.001) in sICAM-1 levels between ill and healthy neonates from the group with ChA (191,8 +/- 73.9 v. 143,4 +/- 31.9 ng/ml) but not without ChA. No difference was found in sICAM-1 levels between groups of healthy neonates born after pregnancy complicated and not complicated with ChA., Conclusions: coexistence of ChA and early onset infection in neonates enhanced the cord blood sICAM-1 levels. Healthy newborns born from pregnancy complicated by ChA do not react by increasing cord blood sICAM-1 levels. It is not possible to exclude early onset infection in neonates on the basis of normal cord blood sICAM-1 levels, because ill newborns born after pregnancy not complicated with ChA also do not react with increasing sICAM-1 production at birth.

Unlabelled: THE AIM of this study was to evaluate the usefulness of determining the concentration of procalcitonin (PCT) in the blood of pregnant women, in amniotic fluid and in umbilical blood as a predictor of intrauterine or infant infection., Material and Methods: the study was conducted on the following material: pregnant women s blood, amniotic fluid and umbilical blood taken during delivery from 60 women and 60 infants. In this group there were 30 vaginal deliveries and 30 deliveries by caesarean section. The PCT concentration was determined by an immunoluminometrical method (ILMA) using two antigen specific monoclonal antibodies; method sensitivity was 0.3 ng/ml. The determining precision was 5-10%. In statistical analysis the U Mann- Whitney test, chi square and ROC curve were employed. A p value less then 0.05 was considered as statistically significant., Results: statistically significant increase in concentration of PCT (p<0.049) was found in umbilical blood of infants whose mothers had intrauterine infection, while such a correlation was not found either in the pregnant women's blood nor in the amniotic fluid. The low levels of AUC indicators found in all analyzed systemic fluids indicate minor usefulness of PCT as an indicator allowing predictions of infant infections. PCT concentrations in the amniotic fluid in comparison with concentrations of PCT in pregnant women's blood and in umbilical blood showed the highest value as a predictor of infection in infants after delivery (respectively AUC - 0.599; 0.582; 0.545). However, low levels of indicator LR - 1.35 demonstrate a nonsignificant value of this indicator as a predictor of infection in infants independent of infection in pregnant women, infection in pregnant women and their infants, or premature delivery., Conclusions: 1. Clinical symptoms of infection in pregnant women are accompanied by increased concentration of PCT in the umbilical blood. 2. The absence of symptoms of infection in a pregnant woman, infection in infant or simultaneous infection in infant and pregnant woman is not a predictor of concentrations of PCT in pregnant woman blood, in amniotic fluid nor in umbilical blood. 3. Examining the concentration of PCT in blood of pregnant women, in amniotic fluid and in umbilical blood is not a clinically useful indicator predicting intrauterine infection in infant.

Objective: Meconium-stained amniotic fluid at term gestation is a predictor for adverse perinatal outcome and is associated with increased peripartum infections, independent of other risk factors. The aim of our study was to evaluate concentrations of inflammatory mediators (such as cytokine IL-6 and intracellular adhesion molecule ICAM-1) and values of hematological parameters of cord blood in presence or absence of meconium in amniotic fluid in term labor., Material and Methods: Cord blood samples were obtained from 66 term normal neonates immediately after birth, Soluble ICAM-1 and IL-6 concentrations were measured with ELISA R&D Systems kits. The umbilical blood specimen was analyzed using an automated hematology cell analyzer. Blood films were stained using May-Grünwald-Giemsa method., Results: There were no difference in concentrations of ICAM-1 and IL-6 in cord blood in groups with or without meconium-stained amniotic fluid. The mean count of umbilical nucleated red blood cells and white blood cells was significantly higher in meconium group. There was no correlation between the cord blood hematological values and ICAM-1 or IL-6. There was also no correlation between IL-6 and ICAM-I and duration of labor. The mode of delivery influenced cord blood IL-6 levels., Conclusions: There was no influence of meconium-stained amniotic fluid on cord blood IL-6 and ICAM-1 levels. Changes in hematological parameters in cord blood in meconium passage can suggest either fetus hypoxia or infection. Significant differences of concentrations of fetal IL-6 were associated with the mode of delivery.

Unlabelled: The analysis of the hematological variables of umbilical cord blood can be useful in broadening our knowledge of both physiological and pathological processes undergoing during prenatal period., Objectives: The aim of our study was to evaluate the hematological parameters of umbilical cord blood in cases of either the abnormal fetal heart rate or the confirmed fetal acidosis., Material and Methods: A study group consisted of 458 neonates, live-born term of 38 to 41 completed weeks of single gestation. In each case, the hematological cord blood parameters were assessed. Fetal acidosis was diagnosed when the umbilical cord blood pH was below 7,15. Fetal heart rate (FHR) was assessed according to FIGO criteria. Statistical analysis was conducted using Mann-Withney tests, analysis of variance, p-value < 0.05 was considered as significant., Results: The values of WBC (16,5 vs. 13,8x109), NRBC (25,1 vs. 7,3 /100 WBC) and HCT (51,8 vs. 46,5%) were higher in cases of fetus acidosis compare to non-acidemic fetuses. The significant differences in RBC, PLT, NRBC, HCT, HG were observed between group with abnormal and normal FHR., Conclusions: Fetal distress resulted in significant changes of the hematological variables in umbilical cord blood. Fetal hemopoetic system responds in specific manner to asphyxia. A precise analysis of fetal hematological variables may help to establish an exact onset and degree of fetal hypoxia.

Cadmium, lead, selenium and zinc levels were determined in placenta, maternal blood and cord blood of 53 women at delivery from Gdansk region. Non-smokers [NS], passive smokers [PS] and smokers [S] were identified by the questionnaire. Our results suggest that there is no smoking impact on the levels of determined elements in placenta. Smoking women have higher Cd and Pb blood levels than mothers who never smoked (p < 0.01). Selenium levels in maternal and cord blood were higher in non-smoking group than in smokers (maternal blood NS vs S p < 0.01; cord blood NS vs S p < 0.001), but there is no smoking impact on the zinc levels in the study tissues. We also investigated the negative influence of tobacco smoke exposure on the distribution of the micro-elements in the feto-placental unit and that the ratio of Zn/Cd and Se/ Pb is higher in all tissues of non-smoking than smoking women.

In Poland, tobacco smoking by women in a procreational age as well as the pregnant women is a common phenomenon. The aim of the conducted research was to assess the usefulness of cotinine markers in different biological materials--mother and newborn's urine, cord blood se. rum, placenta--as a biomarker of tobacco smoking by delivering women, and dependence between these biomarkers and the newborn's health state. 218 pregnant women (117 smokers and 101 non-smokers), who were checked in at the Perinatology and Gynecology Clinic of the University of Medical Sciences in Poznan, took part in the first stage of the research (period between the twelfth and sixteenth week of pregnancy) carried out between years 2004-2006. In the second stage, 201 pairs of women (89 smokers and 112 non-smokers) and their newborns were checked after the women came to hospital to deliver. The research that was conducted showed that both cotinine in the urine of delivering women and in the urine of newborns as well as in the cord blood serum may be used as a biomarker of exposure of a foetus to tobacco smoke. For practical reasons, it must be assumed that the delivering women urine should be the material from choice. The research did not indicate the usefulness of the determination of cotinine in the placenta, in order to assess the exposure of the foetus to the components of tobacco smoke. On the other hand, again it confirmed the influence of tobacco smoking on the newborn's birth parameters, a correlation between the birth weight, body length and cotinine concentration in the urine of a mother makes it possible to predict the lowering of the antropometric parameters of the newborn as a result of tobacco smoking by pregnant women.

Tobacco smoking causes oxidant stress in pregnant women and may have a similar effect in fetus. Vitamin A and beta-carotene are natural factors protecting cells from damaging influence of free oxygen species.Therefore the aim of the study was to estimate the effect of tobacco smoking during pregnancy on concentration of vitamin A and beta-carotene in blood of mother and newborn. Healthy women in III trimester of pregnancy were divided into non-smoking (n = 40) and smoking group (n = 35) according to the concentration of cotinine in serum and urine. Level of carotenoids was measured by HPLC (high pressure liquid chromatography) method in plasma of matched-maternal cord pairs. We observed that, in smoking women group concentration of vitamin A was lower in plasma of mothers as well as in cord blood of newborn (p < 0.001) and amounted respectively only 80% and 70% of that observed in non-smoking mother and their child. In smoking group plasma level of beta-carotene was significantly lower (by 30%; p < 0.0001) as compared with non-smoking matched-maternal cord pairs. Plasma level of vitamin A was significantly correlated with concentration of pcarotene both in smoking and non-smoking pregnant women (r = 0.70, p < 0.001; r = 0.57, p < 0.001). The similar correlation was observed in umbilical cord blood in both groups (r = 0.81 and r = 0.82; p < 0.001). Reduced concentration of vitamin A and beta-carotene in matched-maternal cord pairs suggest that consumption of this antioxidant for neutralization of free radicals present in cigarette smoking is enhanced.

Purpose: To estimate correlation between concentration of antioxidant system parameters in red blood cells in premature infants and prevalence of ROP MATERIAL AND METHODS: We examined 16 premature infants with the average birth weight of 1071 g and gestational age of 29.1 weeks. Supraoxide dismutase (SOD), reduced glutatione (GSH), and glutathione peroxidase (GSH-Px), were measured at day 1 (cord blood), 7-th and 14-th day after birth. Premature infants had ROP screening. The control group included 12 infants born at term., Results: 8 premature infants had ROP There were higher levels of SOD, GSH and GSH-Px in premature infants with and without ROP than in control group. Premature infants with ROP had lowest levels of GSH., Conclusions: The glutathione status of red blood cells as a oxidative stress index in premature infants might be a reliable parameter, facilitating the early recognition of patients in immediate danger of ROP development.

Objectives: Maternal smoking during pregnancy is known to be associated with not only intrauterine fetal growth retardation or low birth weight but also causes disturbances in postnatal growth and development. The prime role of oxidative stress in the pathogenesis of adverse pregnancy outcomes is almost universally accepted., Design: The aim of the study was to estimate the effect of tobacco smoking during pregnancy on concentration of lipid peroxidation products (malondialdehyde - MDA) in blood of mother and newborns., Materials and Methods: 147 healthy, pregnant women were divided into non-smoking (n = 85) and smoking group (n = 62) according to questionnaire declaration and confirmed by cotinine concentration in serum and urine. Level of MDA was measured by fluorimetric method in plasma and in erythrocytes of mothers and umbilical cord blood., Results: We found that, in group of women smoking during pregnancy concentration of malondialdehyde was higher in plasma and in erythrocytes when compared to group of tobacco abstinent. Also in cord blood of newborns of smoking mothers level of MDA was significantly higher in plasma (p < 0.05) as well as in erythrocytes (p < 0.01) than in control group., Conclusion: The presented results indicate that smoking during pregnancy may promotes free radical damage in growing fetus and newborns therefore stimulates metabolic disorders dependent on oxidative stress.

Objectives: To assess cord blood leptin levels in preterm and small-for-gestational age neonates and determine whether fetal leptin levels correlate with selected clinical parameters associated with prematurity and undernutrition at birth., Design: Study of preterm newborns (p-AGA; n = 31) and small-for-gestational age (t-SGA; n = 23) cases in a population of neonates born in Szczecin between September 2001 and June 2002., Methods: Fetal cord blood was sampled after delivery. Leptin levels were measured by RIA. Anthropometric data (birth weight, birth length, head and chest circumferences, body mass index, Ponderal index) were also recorded., Results: Cord blood leptin levels did not differ significantly between p-AGA and t-SGA neonates with similar birthweight. Among the two groups of newborns the correlations between fetal leptin and anthropometric data were only observed in p-AGAs, but not in t-SGA group., Conclusions: We suggest that cord blood leptin level depends on body mass rather than maturity of newborn. It is also hypothesized that leptin level in SGA neonates is determined by other than anthropometric parameters used in this study.

This paper presents the results of the determination of serum anion gap in arterial and venous umbilical cord blood obtained from a carefully selected group of 47 healthy term newborns. In the arterial blood, the following concentrations of particular anions were found: chloride - 102.85 +/- 4.35 mmol/l, bicarbonate - 22.26 +/- 2.67 mmol/l, protein anions - 11.89 +/- 1.00 mmol/l, and residual anions - 14.26 +/- 4.35 mmol/l, while in the venous blood these values were: chloride - 104.28 +/- 4.14 mmol/l, bicarbonate - 20.79 +/- 2.70 mmol/l, protein anions - 12.48 +/- 1.23 mmol/l, and residual anions - 13.03 +/- 3.06 mmol/l. Provided strict clinical and biochemical (acid-base balance and blood gases) selections criteria are applied, these data are likely to represent normal values for term newborns and can be the basis for comparison of umbilical serum anion gap in newborns under depressed conditions, like asphyxia. As discussed, the role of serum anion gap studies in the diagnosis of the type of metabolic acidosis, as well as in the monitoring of neonatal therapy is most important.

During controlled, randomized prospective trials, fetal arterial hemoglobin saturation (FSpO2) was estimated during 25 underwater labors and compared to results obtained from 34 classical deliveries. Mean fetal hemoglobin saturation during the first stage of labor was similar in both groups while a gradual decreasing trend in fetal FSpO2 was noticed throughout the progress of labor. In the second stage of labor higher mean FSpO2 values were observed in the group of fetuses born underwater. The author emphasized in discussion that underwater labor constitutes delicate and mild procedure particularly for the fetus.

The aim of the study was to determine the concentration of lead and cadmium in blood of 83 pregnant women from Szczecin and in umbilical cord blood of their newborns. Mean concentration of lead in women was 2.56 micrograms/dl and in umbilical cord blood was 2.01 micrograms/dl. The mean concentration of cadmium in women was 0.056 microgram/dl and umbilical cord blood was 0.21 microgram/dl. A positive correlation was noted between lead concentration in maternal and umbilical cord blood (r = 0.59). The similar correlation between cadmium concentration in maternal blood and umbilical cord blood was observed. The transplacental gradient for lead was 78.52%, and for cadmium--37.5% respectively.

The smoking habit is widely spread between pregnant women too. Tobacco smoke components have negative influence on infant's development. In human trans-3'-hydroxycotinine is besides cotinine, one of the main nicotine metabolites. The research covered 17 patients with physiological pregnancy, which ended with delivery through natural passages at term. All women were active smokers as we revealed before according to their serum cotinine concentrations. Assessment of cotinine and trans-3'-hydroxycotinine concentrations has been done by the use of very sensitive liquid chromatographic techniques in the mothers venous blood samples and in the mixed umbilical cord blood of the newborns. Obtained results of the research have been statistically analysed using the STATISTICA package. Significance level p < 0.05 has been adopted as statistically relevant. In conclusion, trans-3'-hydroxycotinine concentrations were significantly lower in the neonates then in their smoking mothers and there was strong positive linear relationship between maternal and neonatal trans-3'-hydroxycotinine concentrations. The value of linear correlation coefficient was 0,7 with a p-value of 0.05.

Objective: The aim of the study was to evaluate the usefulness of the intrapartum fetal pulse oximetry in anticipating the neonatal outcome., Materials and Methods: The saturation of the fetal blood (SpO2) was measured during labor with non-invasive pulse oximeter designed for fetal application. The average, minimum and maximum SpO2 were evaluated separately for the first and the second stage of labor. The average SpO2 of the fetus was compared to neonatal condition assessed by umbilical vein pH, pO2 and pCO2 and according to Apgar score., Results: Twenty patients have been monitored with fetal pulse oximetry. All those patients had normal vaginal delivery. During the first stage of labor, the average fetal SpO2 was 51.94 +/- 8.03%, the minimum SpO2 was 38.35 +/- 9.15%, and the maximum SpO2 was 63.35 +/- 7.75%; in the second stage of labor average fetal SpO2 was 43.82 +/- 7.16%, minimum SpO2 was 34.35 +/- 7.79% and the maximum SpO2 was 50.94 +/- 8.37%. A significant decrease in fetal average and maximum SpO2 occurred from stage I to stage II of labor (average SpO2: 51.94 +/- 8.03% vs. 43.82 +/- 7.16%, p = 0.0002; maximum SpO2: 63.35 +/- 7.75% vs. 50.94 +/- 8.37%, p < 0.00001). The significant correlation between the average SpO2 during the first stage of labor and umbilical vein pH (R = 0.60, p = 0.02) and pO2 (R = 0.54, p = 0.04) was found. No relationship between fetal SpO2 in the first and second stage of labor and Apgar score was observed., Conclusions: 1. The second stage of labor results in significant decrease in fetal SpO2. 2. The fetal SpO2 > 30% in the first and second stage of labor is related to good neonatal outcome. 3. The fetal SpO2 assessment in first stage of labor seems to be important in newborn's acidosis and hypoxemia predicting.

This study was done in 83 mothers and their 83 newborns with the aim of determining the levels of lead and cadmium in maternal venous and umbilical cord blood. Hair levels were also measured in 60 mothers and 14 newborns. The course of pregnancy was normal in each case and all deliveries were by natural forces at the Department of Obstetrics and Gynecology, Hospital in the City of Szczecin. The mean age of mothers was 26 and the postpartum Apgar score of each child was normal. The relationship between levels of lead and cadmium in blood and hair of mothers and newborns was examined and their influence on the general health status of the newborn was assessed, in particular on the body weight and length, head and chest circumferences. The influence of socio-economic conditions on levels of lead and cadmium in blood and hair of mothers and newborns was also examined. Levels of the two toxic metals in blood and hair were determined by means of atomic absorption spectrometry done in reference laboratories. The results were statistically compared taking the level of significance as p = 0.05. It was found that levels of lead and cadmium are lower in mothers and newborns from Szczecin than values reported by Polish and international investigators and are markedly below the upper permissible limit. Levels of lead and cadmium in maternal venous blood were 0.133 mumol/L (2.75 micrograms/dL) and 0.008 mumol/L (0.09 microgram/dL), respectively, and were significantly higher than levels in cord blood: 0.103 mumol/L (2.14 micrograms/dL) and 0.0025 mumol/L (0.028 microgram/dL). The concentration of lead and cadmium in cord blood was 78% and 33% of the concentration, respectively, in maternal blood. This difference seems to reflect the activity of the placental barrier which apparently is more effective in the case of cadmium. Contrary to this pattern, hair levels of both metals were lower in mothers (Pb 0.004 mumol = 0.86 microgram/g dry mass, Cd 0.0012 mumol = 0.13 microgram/g dry mass) than in newborns (Pb 0.02 mumol = 5.07 micrograms/g dry mass, Cd 0.002 mumol = 0.22 microgram/g dry mass). These findings indicate that accumulation of lead and cadmium begins in fetal life. A statistically significant correlation was revealed between maternal venous and umbilical cord blood levels of lead (r = 0.59, p = 0.000001) and cadmium (r = 0.23, p = 0.04). The levels of both metals seemed to be without effect on the health status and body dimensions measured. Significantly higher levels of cadmium were detected in women who reported a history of abortions. Concentrations of lead and cadmium in blood or hair were not related to education, employment during pregnancy, past infectious diseases, number of pregnancies, or dwelling conditions.

The study was undertaken to determine whether PIVH and PVL in neonates are related to cord blood TNF levels and chorioamnionitis. The study material consisted of 54 neonates--31 preterm and 23 full-term. 39 of those babies were born to mothers with clinical signs of intrauterine infection, but only in 20 cases histologic chorioamnionitis were recognised. In the whole study newborns brain ultrasound examination was taken during the first 3 days of life. Abnormal head ultrasound (PIVH--17 cases or PVL--6 cases) was diagnosed in 23 babies. That was found that brain damage, recognised during neonatal period, was mainly connected with prematurity and signs of maternal infections but not with cord blood TNF levels. We conclude that prolongation of pregnancy as well as early recognition and proper treatment of intrauterine infection can prevent PIVH and PVL in neonates.

Objective: The purpose of the study was to assess the clinical value of fetal fibronectin assay in the group of women presenting with preterm contractions and cervical changes., Study Design: We prospectively evaluated 82 patients between 23-34 weeks of gestation presenting with signs and symptoms of preterm labor, intact membranes and cervical dilatation < 3 cm. In all cases cervico-vaginal samples were collected and assayed for the presence of fetal fibronectin. The primary outcome was delivery < or = 28 days from examination., Results: The rate of preterm delivery (< 37 weeks) was 25.6% (21/82) and 17.1% (14/82) of the patients delivered < or = 28 days from the examination. The mean Bishop score was significantly higher in patients delivered < 28 days (5.9 +/- 1.2 vs 4.7 +/- 1.4; p = 0.004). Positive result of fFN (> 0.05 mg/ml) was found in 71.4% of patients that were delivered < or = 28 days and in 7.4% delivered > 28 days (p < 0.001). For predicting delivery < or = 28 days the positive fFN testing had sensitivity of 71.4%, specificity of 92.7%, PPV of 66.7% and NPV of 94%. The cutoff value for Bishop's score > or = 5 had sensitivity of 85.7% and specificity of 48.5%. Performing fFN testing only in patients with Bishop score > or = 5 resulted in the sensitivity of 71.4%, specificity of 95.6%, PPV of 76.9% and NPV of 94.2%., Conclusions: Fetal fibronectin is a very good predictor of imminent preterm delivery. It needs further research whether performing of the fFN assay can be limited only to the patients with the estimated Bishop's score > or = 5.

The aim of neonatologist is to anticipate clinical status of newborn immediately after delivery. Important are all parameters helpful in determining perinatal outcome. Particular attention is paid to proinflammatory cytokines: IL-1 alpha, IL-1 beta, IL-6, IL-8 and TNF alpha. The aim was to verify a relationships between umbilical cord blood cytokines and way of delivery, umbilical factor and clinical status of newborn in perinatal period. Newborns with lower 10 min Apgar score had higher levels of umbilical blood cytokines. Elevated IL-6 and IL-8 levels were found in newborns with subsequently diagnosed bacterial infection. Higher levels of cytokines were found in umbilical blood of newborns who passed meconium into the amniotic sac and who required an incubator. Proinflammatory cytokines, especially IL-6 and IL-8 may indicate the newborn clinical status in perinatal period.

The aim of our study was to compare hematological values of the cord blood in the presence and absence of meconium-stained amniotic fluid (MSAF). MSAF was associated with decreased total platelet count, increased values of platelet distribution width and red blood cell distribution width. The mean nucleated red blood cells was significantly higher in meconium group. The values of red blood cells, white blood cells, reticulocytes counts and their fractions (HFR,MFR,LFR,IFR) were no different in cord blood of neonate exposed to meconium and in those who were not. These findings can suggest that MSAF contribute to fetal infection rather than hypoxia.

The aim of the study was to evaluate the influence of maternal smoking on kynurenic acid (KYNA) levels in venous and arterial umbilical cord blood of neonates. Statistically significant lower concentration of KYNA in umbilical arterial blood of smoking mothers neonates was observed. The lower levels of KYNA in blood may reflect the smaller resistence of neuronal tissue to damages under hypoxic-ischemic conditions in neonates affected during intrauterine life by smoking.

Unlabelled: The aim of the study was evaluation, whether cord blood insulin (Ic) and erythropoietin (EPO) levels differ in accordance with mode of delivery: cesarean section (CS) or vaginal delivery (VD)., Material and Methods: The study was performed in the diabetic group consisted of 148 newborns of diabetic mothers (NDM)--90 of them with GDM and 58 with IDDM as well as in the control group consisted of 100 newborns born to healthy mothers. 52.0% of NDM and 38.0% control subjects were delivered by cesarean section. The most frequent reason for performing CS in the diabetic group was fetal distress before labor and in the control group--fetal distress during labor. Cord blood Ic and EPO levels were compared in accordance with type of delivery: CS or VD. Into statistical analysis Mann-Whitney test was used., Results: There were found that cord blood Ic and EPO levels in NDM born by CS are significantly higher than in those born by VD (Ic--38.2 +/- 41.5 versus 26.6 +/- 38.6 mIU/ml adequately and EPO--51.8 +/- 76.0 versus 26.8 +/- 29.9 mU/ml adequately). There were no such differences in the control group., Conclusions: 1. Fetal hyperinsulinemia in perinatal period is often connected with occurrence of indications for performing cesarean section in pregnant women with diabetes mellitus. 2. Cesarean section in diabetic pregnant women is often connected with previous fetal hypoxia.

The relationship between cord blood erythropoietin (EPO) and maternal HbA1c and fructosamine levels were examined in the aim to answer a question, whether occurrence of prenatal hypoxia in newborns of diabetic mothers depends from maternal glycemic control during the last weeks of pregnancy. The study was performed in the group of 178 mothers and newborns divided into two groups: diabetic and control. The diabetic group consisted of 116 mothers (33 with IDDM and 83 with GDM) and newborns and the control group consisted of 62 healthy mothers and newborns. Maternal HbA1c (Micro Column Test BIORAD Prospecta) and fructosamine (Roche fructosamine Test) levels were estimated on the day of delivery. Cord blood to estimate EPO (radioimmunoassay) and fructosamine levels were drawing immediately after delivery the babies. The relationship between the study parameters were calculated on the basis of a covariance analysis test. In the diabetic group the significant positive correlation between EPO and maternal HbA1c and fructosamine levels was found as well as between EPO and fetal fructosamine levels. We conclude that higher levels of cord blood EPO are associated with poor maternal glycemic control during the last weeks of pregnancy.

The aim of the study was to examine whether an association between cord blood insulin level (Ic) and maternal glycemic control, duration of pregnancy as well as neonatal birthweight exists. The study was performed in diabetic group consisted of 149 diabetic mothers (91 with GDM and 58 with IDDM) and 149 their babies as well as in the control group consisted of 100 healthy mothers and 100 their babies. Maternal glycemic control was indirectly assessment by using HbA1c and fructosamine levels estimated on the day of delivery. That was found a significant positive correlation between Ic and maternal HbA1c and fructosamine levels as well as between Ic and neonatal birthweight in the diabetic group. That was also found the significant negative correlation between Ic and duration of pregnancy in the diabetic group. We conclude that fetal hyperinsulinemia is a result of poor glycemic control during the last weeks of diabetic pregnancy. Furthermore the significant association exists between cord blood hyperinsulinemia and preterm delivery as well as higher birthweight of newborns born to diabetic mothers.

Design: To examine whether perinatal hypoxia increases the risk of occurrence of hypoglycaemia--between first and second hour of life--in newborn of the diabetic mother., Material and Methods: The study material consisted of 151 newborns born to 58 pregestational and 93 gestational diabetes mothers. The occurrence of hypoglycaemia was examined in accordance with some perinatal hypoxia indicators such as: 1 and 5 minutes Apgar scores, umbilical arterial blood gas analysis and cord blood erythropoietin (EPO) level., Results: Newborns of the diabetic mothers in whom hypoglycaemia was recognised had lower 1 minutes Apgar scores, lower pH values, higher pCO2 values and higher EPO levels than those, in whom normoglycaemia was recognised., Conclusions: Low 1 minutes Apgar scores and occurrence of even mild perinatal hypoxia are factors increasing the risk of hypoglycaemia in the group of newborns of the diabetic mothers in the time between first and second hour of life.

The aim of our study was to estimate the concentration of lipid peroxidation products and antioxidant system activity in cord blood and placental homogenates of 13 pregnant women with type I diabetes, 15 patients with gestational diabetes and 16 healthy pregnant women. Malondialdehyde (MDA) concentration, glutathione (GSH) content and the activity of CuZn superoxide dismutase (SOD) (Bioxytech, Oxis International S. A.) were measured. MDA and GSH levels increased significantly, whereas SOD activity was markedly diminished in diabetics, especially in these with type I, in comparison with the control group. Our results support the hypothesis that diabetic pregnant women and their fetuses/neonates are exposed to an increased oxidative stress. Moreover, we suggest that the measurement of oxidative stress level may be useful in clinical practice to assess fetus/neonate state and the risk of possible complications.

The aim of the paper was to evaluate the activity of inhibitor of the phytoagglutinin Pisum sativum (IfPs) in sera of mothers' and umbilical blood of their newborns in confrontation with the course of pregnancy and delivery. The investigations involved 152 tests of sera collected from women delivering at Department of Obstetrics and Perinatology in the Institute of Gynecology and Obstetrics PMU in Szczecin in the years 1992-1993, as well as 156 samples of sera stemming from their newborn infants and were taken from the umbilical cord vessels. The method of investigations being used in the paper was the reaction of inhibiting the phytohemagglutination, wherein the inhibiting action of sera in bearing women and of sera in umbilical blood exerted on agglutinating one was assessed in relation to human erythrocytes of the group 0 with Pisum sativum lectin properties. The accepted titer of inhibitor of the agglutinin Pisum sativum (IfPs) was expressed as the highest dilution of serum, at which complete inhibition of phytohemagglutination was still preserved. The performed investigations have disclosed statistically significant differences between the activity of IfPs occurring in sera of the mothers and the inhibiting factor in umbilical blood sera of the newborns (Tab. 1). No effect of the duration of pregnancy and the course of pregnancy on the IfPs activity in sera of mothers was disclosed. The absence of inhibitor of Pisum sativum lectin in umbilical blood sera was essentially frequently recorded in premature termination of pregnancy between 31-37 weeks of its duration as well as in sera of newborns born by cesarean section and newborns with birth mass being equal or lower than 2500 g in comparison to sera of full term newborns born by forces of nature (Tab. 2, 3, 5). The birth status of newborns according to Apgar scale did not have any influence of IfPs activity in their sera, however, IfPs activity in sera of umbilical blood was statistically significantly more frequent in cases of deliveries lasting longer than 4 hours as compared to its activity in cases of deliveries being shorter than 4 hours (Tab. 4). On the basis of results of the performed investigations it has been revealed that at the period of intensive divisions of cells, their differentiation (intrauterine period of fetal development) the activity of the inhibitors of phytohemagglutination appearing in body fluids of human being is residual only or does not appear at all. The IfPs activity was intensifying with the progress of intrauterine maturation of the fetus. In the paper closer attention was focussed on the new point of view concerning the role of phytoagglutinins and endogenic lectins as well as their inhibitors in various pathological processes particularly neoplastic ones.

Objectives: Presumable role of leptin, the product of ob gene, is signalling the energy stores to the brain. Moreover, leptin is also responsible for the food intake through the influence on the appetite. Since the fetal energy metabolism is strongly dependent on maternal nutritional health, leptin should be of peculiar importance during pregnancy., Material and Methods: Fifteen full-term pregnant women (mean age 27.5 +/- 6.4 years; mean gestational age 39.2 +/- 2.5 weeks; mean parity 2.1 +/- 0.9) were enrolled into the study. Immediately after delivery blood was taken from mother antecubital vein and from the umbilical cord vessels (vein and artery). Leptin concentrations in the sera were estimated by the RIA method using Linco Research Human Kit-USA., Results: The highest mean serum leptin concentration was found in maternal compartment (21.9 +/- 12.9 ng/ml) and this value was significantly higher than observed in umbilical artery 4.36 +/- 2.65 ng/ml; p < 0.001). The leptin concentration in umbilical vein was 13.1 +/- 10.7 ng/ml and this value was not statistically different than concentration found in umbilical artery (p = 0.054) and mother antecubital vein (p = 0.1). A strong positive correlation was found between maternal serum leptin concentration and maternal body mass (r = 0.5; p < 0.001) and between fetal umbilical artery leptin concentration and newborn body mass (r = 0.7; p < 0.0001)., Conclusions: Among full term pregnant women strong positive correlation between serum leptin concentration and body mass was found. Even better correlation was observed between umbilical artery leptin concentration and newborn body mass. Relatively big serum leptin concentration gradient between mother and umbilical vessels indicates that placenta might play an important role in leptin production.

It is accepted that alpha-2-M may serve as an important factor for the regulation of homeostasis. For these reasons it is valuable to determine its concentration in some clinical conditions. We have found that the level of alpha-2-M is evidently higher in hypotrophic newborns than in neutrophic newborns. It is interesting to note that the mothers of hypotrophic newborns also exhibit increased concentration of alpha-2-M in comparison to the mothers of eutrophic newborns. No differences were observed in concentration of this inhibitor between mothers and this newborns in both groups. Taking under consideration these findings it seems there is an inverse relationship between cord serum alpha-2-M concentrations and birth weight of newborns. Probably the increase of this inhibitor may reflect in some extent its function as moderating factor high susceptibility hypotrophic newborns for infections since alpha-2-M plays so crucial role in inflammatory processes.

In the study there was estimated maternal (Fm) and cord blood (Fc) fructosamine levels in 151 diabetic (58 PGDM and 93 GDM) and 100 control subjects on the day of delivery. It was found that Fm and Fc levels in PGDM and GDM groups were significantly higher than in the control group. It was also found the significantly positive correlation between Fm and Fc levels in all study groups. It leads to the conclusion that pregnant diabetic women and their fetuses were hyperglycemic during the last 2 weeks of pregnancy. Our results indicate that on the basis of maternal fructosamine levels it is possible to apply on indirect estimation of metabolic status of the fetus.

There were performed measurements of AFI in 32 women during labour and they were referred to pH of neonatal umbilical vein. It was proved by significant statistic relation p = 0.034 (r = 0.375) between AFI and pH of umbilical vein blood. In anticipation of fetal acidosis with AFI < or = 5 cm with pH < or = 7.25 it was determined that: sensitivity 66.7%, specificity 58.6%, positive predictive value 14.3%, negative predictive value 94.4%, false positive 85.7%, false negative 5.6%, accuracy 59.4%. Obtained data do not differ from those given in literature. Measurements of AFI < or = 5 cm help in identification of the risk group (fetus in danger, of acidosis during labour) but due to low specificity and low positive predictive value (66.7% and 14.3% respectively). Clinical decisions should be made after consideration the result of the other tests of fetal well-being.

The efficiency of glycemia control was compared in two groups of insulin dependent diabetic pregnancies treated with insulin, with and without the aid of the Camit-Diacomp system. The efficiency of glycemia control was analysed in all three trimesters of pregnancy. Mean diurnal fluctuations of glycemia levels in both study groups were compared. The clinical state of newborns, their glycemia and insulin levels in cord blood were analysed as well. No statistically significant differences of glycemia levels between the two compared groups of patients were found, however the observed significant differences of the HbA1C levels between these groups can speak in favour of the efficiency of treatment under the Camit-Diacomp system, which enables a more precise self control of the treatment and dosage of insulin.

The sixty-seven newborns were investigated. The umbilical cord blood samples were used to determine following indices: total cholesterol, LDL, HDL2, HDL3-cholesterol, total phospholipids, LDL, HDL-phospholipids, triglycerides and apolipoprotein B. The chi 2 test indicated correlations between increased levels of triglycerides, phospholipids LDL and cholesterol HDL2 and decreased level of cholesterol LDL in the group of newborns with the lowest delivery body mass.

CRP was measured in cord blood of 41 neonates born by healthy mothers and those with either risk of infection or its obvious clinical symptoms, and in sera of 122 newborn babies from infection risk group. Results excluded cord blood as a possible specimen for CRP estimation, because of very low values, at lower limit of sensitivity of the immunoturbidimetric method, and showed a correlation of serum CRP and clinical condition and its usefulness in monitoring of anti-bacterial therapy.

The activity of N-acetyltransferase (NAT) and catalase was measured in the tissues of placenta, full venous blood and full umbilical cord blood in 141 complicated pregnancies. The control group consisted of 34 physiological pregnancies. The enzymes activity was marked by use of biochemical methods. It has been shown that NAT and catalase is the most active in the group of physiological pregnancies. The decrease of NAT and catalase in venous and umbilical cord blood is correlated with the decrease of the activity these enzymes in placenta.