Different concentration of human cord blood HMGB1 according to delivery and labour: A pilot study.

OBJECTIVE: Oxidative stress is involved in several maternal conditions characterized both by an increase in free radicals synthesis and a parallel decrease in the antioxidant activity. Parturition induces considerable oxidative stress and many inflammatory mediators, among which HMGB1, are involved from the beginning of pregnancy to the birth of the infant. We evaluated serum cord blood HMGB1 levels in a population of neonates to investigate correlation with mode of delivery, as well as the influence of labour. SETTING AND PATIENTS: The study subjects were 325 neonates delivered at University Hospital "G. Martino" of Messina over an 18-month period. Following cord separation, venous blood sampling was performed on umbelical cords. RESULTS: In the cord venous blood, we found HMGB1 values significantly more elevated in spontaneous vaginal group when compared to elective or emergency caesarean section group. Regarding labour, umbilical cord venous blood HMGB1 levels were significantly higher in the spontaneous and induced labour group, compared to non-labouring women. CONCLUSION: These results could highlight a possible role of HMGB1 during birth time related to mode of delivery and labour.

[Comparison between pre- and postnatal echographic screening of malformative uropathies]. / Confronto tra lo screening ecografico pre- e postnatale delle uropatie malformative.

AIM: The aim of this study has been to compare the validity of postnatal echographic screening in respect of prenatal echography in early diagnosis of malformative uropathies (MU). METHODS: In 6578 infants, who have been submitted to fetal echography, and to a postnatal screening of MU in our Neonatal Service of Echography (University of Messina), we have compared the diagnostic agreement of prenatal with postnatal echography. RESULTS: Our comparison demonstrates that, in respect of postnatal screening, only 35.71% of pyelectasies and 73.17% of hydronephrosis have been diagnosed by fetal echography, and, in particular, only 18.75% of no-dilated MU. CONCLUSIONS: These data confirm that, in our country, the postnatal screening of MU has still significance and suggest that, before excluding this screening, it is necessary to verify everywhere the validity of fetal echography.

Incidence of meconium aspiration syndrome in term meconium-stained babies managed at birth with selective tracheal intubation.

The delivery room management of infants born through meconium stained amniotic fluid (MSAF) remains controversial. The aim of this prospective study was to evaluate maternal and neonatal characteristics of MSAF infants and the incidence of meconium aspiration syndrome (MAS) in routine delivery room management which reserved selective intubation for depressed/asphyxiated babies. Between October 1993 and September 1997, a consecutive sample of 3745 full-term infants was analyzed. Of these, 361 were MSAF infants. No significant difference in maternal age, parity, gestational age, sex, low 1 and 5 minute Apgar scores, metabolic acidemia, or need for endotracheal intubation was found between MSAF and non-MSAF infants. Only one of the MSAF infants (0.28%), who needed intubation, developed MAS. Identification of postterm pregnancy and prenatal asphyxia is the best prevention of MAS.

[Health status of neonates born to immigrants at the University Polyclinic of Messina in 1993-1998. A case-control study]. / Stato di salute dei neonati figli di immigrati nati presso il Policlinico Universitario di Messina negli anni 1993-1998. Studio-caso-controllo.

The aim of the present case-control study was to verify the incidence and the state of health of the neonates born of extracommunity parents (E.C.) in the our hospital throughout the years 1993-1998. For every neonate born of E.C. we have analyzed two italian neonates born immediately before and after. The parameters analyzed were: nationality, age, and job of the parents, abortions, number of ecography carried out during pregnancy, parity, delivery, gestational age (G.A.), weight at birth, Apgar score, malformations, perinatal mortality and neonatal morbidity. Statistical analyses were performed with the T Student test and the chi-square test. Throughout the 1993-1998 years are born 9285 neonates. Of these 199 (2.4%) were E.C. The 45% of the E.C. derived from the Far East and only the 10% were nomad. The 86% of the E.C. had a job. In the E.C. group the multiparity was significantly higher than in italian group. G.A., birth weight, number of malformation, neonatal morbidity, and perinatal mortality were the same in the E.C. and in the italian neonates. Our data, in disagreement with other Authors, demonstrate that in our hospital the state of health of the E.C. and italian neonates is not different. Because in the our analysis it results that the greater number of E.C. parents had a job, it is likely that the non-observed increased of perinatal mortality and morbidity in the neonates born of E.C. depends on the social integration of E.C.

[Infants born to hypertensive mothers: a clinical-epidemiological study]. / I figli di madre ipertesa: studio clinico-epidemiologico.

The aim of this prospective study was to evaluate the frequency of the hypertensive disorders of pregnancy and their effects on the newborn infants. The study was performed between January 1992 and December 1994 on the 4793 infants born at the Obstetric Divisions of the University of Messina. These 123 infants were born of hypertensive women and 4670 were control infants. Between the two groups of infants there were significant differences with regard to the incidence of nulliparity, prematurity, low Apgar scores at birth and low birth weight. The blood pressure and the haematic parameters were not different between the two groups of infants. Five of the infants born to hypertensive women were referred to the Division of Neonatal Pathology. The low frequency of infants born to hypertensive women observed by us suggests that in our population the hypertensive disorders of pregnancy are understimated. Moreover, the high incidence of preterm and LBW infants confirms that in infants born to hypertensive women the neonatal risks are consequent to fetal growth retardation.