title: Umbilical cord plasma glutathione S-transferase alpha 1-1 levels as a marker of neonatal hepatocellular integrity.
abstract: 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] microg/L and 7.66 [0.78-987.5] microg/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] microg/L and 6.47 [1.58-164.5] microg/L versus 1.47 [0.46-10.4] microg/L, P < .001). Neonates born vaginally demonstrated higher median (range) levels than those delivered by cesarean (13.41 [1.02-1125] microg/L and 5.73 [0.64-172.90] microg/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] microg/L and 8.82 [0.64-120.90] microg/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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital St. Radboud, Nijmegen, The Netherlands.
authors.forename: M F
authors.initials: MF
authors.lastname: Knapen
authors.forename: W Y
authors.initials: WY
authors.lastname: Wong
authors.forename: T P
authors.initials: TP
authors.lastname: Mulder
authors.forename: W H
authors.initials: WH
authors.lastname: Peters
authors.forename: H M
authors.initials: HM
authors.lastname: Merkus
authors.forename: E A
authors.initials: EA
authors.lastname: Steegers
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D036861:Delivery, Obstetric; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005982:Glutathione Transferase / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn / Q000097:blood*; D016014:Linear Models; D008099:Liver / Q000502:physiology*; D008111:Liver Function Tests; D012907:Smoking
chemical_list: D015415:Biomarkers; D005982:Glutathione Transferase