[The effect of tobacco smoking on serum concentration of selected angiogenic factors and somatomedin C in pregnant women and umbilical cord blood]. / Wplyw palenia tytoniu na stezenia wybranych czynników angiogennych oraz somatomedyny C w surowicy krwi kobiet ciezarnych i krwi pepowinowej.

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.

[Evaluation of iron balance in healthy pregnant women and their newborns]. / Badanie gospodarki zelazem u kobiet w przebiegu ciazy niepowiklanej oraz we krwi pepowinowej ich dzieci.

AIM OF THE STUDY: The aim of this study was to evaluate the iron status markers in normal healthy pregnancy as well as the influence of maternal diet on iron concentration in their newborns. MATERIAL AND METHODS: A longitudinal prospective study was conducted in a sample of 69 healthy non-smoking pregnant women under prenatal care of The Institute of Mother and Child. Blood samples were collected in the first, second and third trimesters and from the umbilical vein. Concentrations of ferritin and transferrin were assessed using turbidimetric technique, the concentration of iron--with ferrozine colorimetric method. Pentra 120 analyzer was used to define hematological parameters. Maternal diet was assessed by means of a weekly questionnaire, processed with computer software Dietetyk 2. RESULTS: Hematological parameters in the analyzed blood were normal. The average hematocrit values in the first trimester of pregnancy was 36.7%, in the second--34.92%, in the third--35.95%. The concentration of hemoglobin was 27.82 g/dl, 28.55 g/dl, 27.27 g/dl in the respective trimesters of pregnancy. In the umbilical blood it was 25.84 g/dl (5.2% less than in the maternal blood). The number of erythrocytes was the highest in the first (4.16 mln/mm3), and the lowest in the second trimester (3.92 mln/mm3). The average concentration of iron was the highest in the first trimester--99.61 microg/dl. In the second and third trimester it decreased by 25% and 2% respectively. The concentration was 76.34% higher in the umbilical blood than in maternal blood at the time of labor. The concentration of ferritin in the first trimester was 43.96 microg/l, in the second and the third trimester it was lower by 46% and 29% respectively. It was 126.4 microg/l in the umbilical blood (fourfold higher than in maternal blood). The concentration of transferrin was 321.01 mg/dl in the first trimester and it increased in consecutive trimesters by 36.14% and 5.12%; it was 219.92 mg/dl in the umbilical blood--48% of the concentration of transferrin in the maternal blood at the time of labor. The analysis of an average daily food ration revealed that the supply of iron was 80% of the recommended dose in the first half and only 41% of the recommended dose in the second half of the pregnancy. Fat consumption was 99% and 95% of the recommended dose, respectively. There was a 30%-decrease in the protein and carbohydrates consumption in comparison with the recommended dose in the second half of the pregnancy. CONCLUSIONS: In spite of normal hematological parameters, we observed insufficient supply of iron in the diet of pregnant women, which was demonstrated by a decreased level of ferritin. It should be reason enough to issue dietary recommendations and guidelines for pregnant women in each stage of pregnancy.

[A comparison of serum concentrations of biochemical bone turnover markers in patients with osteosarcoma with good and poor prognosis]. / Analiza stezenia biochemicznych markerów obrotu kostnego u chorych na miesaka kosciopochodnego z korzystnym i niekorzystnym rokowaniem.

UNLABELLED: Osteosarcoma is a primary malignant bone tumor, whose peak incidence occurs in the second decade of life during the adolescent growth spurt. Complex oncological treatment consisted of chemotherapy combined with surgery which substantially increased the cure rate of patients with osteosarcoma, but it is very important to identify patients with poor prognosis and to treat them with more aggressive therapy. THE AIM OF THIS STUDY: To assess serum biochemical bone turnover markers as prognostic indicators in patients with osteosarcoma. MATERIAL AND METHODS: We studied 55 patients from age 5 to 20 years with diagnosed osteosarcoma treated at the Institute of Mother and Child in Warsaw. The studied group was divided into 2 subgroups consisted of 27 patients with favorable (disease remission) and 28 patients with unfavorable (disease progression) prognosis. Venous blood was collected from patients in the morning hours at time of diagnosis, during anticancer treatment and after completion of treatment. Serum osteocalcin (OC), bone alkaline phosphatase (BALP) and C-terminal cross-linking telopeptide of type I collagen (CTX) were analyzed by immunoenzymatic methods. RESULTS: At time of diagnosis, in patients with unfavorable prognosis concentration of bone formation markers were higher (OC by 30% and BALP by 60%) than in those with good prognosis, however, CTX level was similar in both groups of patients. During chemotherapy in patients with poor prognosis we observed higher levels of bone turnover markers in comparison to subjects with favorable prognosis. After the completion of therapy, in patients with progression median values of bone formation markers were over twofold and bone resorption marker about 50% higher as compared to patients with remission of disease. These differences were statistically significant at p < 0.05 for OC, p < 0.001 for BALP and p < 0.01 for CTX. CONCLUSIONS: Our results suggest that bone turnover markers, especially bone alkaline phosphatise may be useful in the monitoring and in the assessment of the efficacy of therapy in children with osteosarcoma. Higher rates of bone formation and resorption during treatment and after its completion are associated with unfavorable prognosis and may indicate progression of disease.

[Influence of vegetarian diet on serum values of homocysteine and total antioxidant status in children]. / Wplyw stosowania diety wegetarianskiej na stezenie homocysteiny oraz calkowita aktywnosc przeciwutleniajaca w surowicy u dzieci.

UNLABELLED: The vegetarian diet may play a preventive role in the development of chronic diseases such as coronary heart and cardiovascular disease. However increase of homocysteine (Hcy) concentration in peoples avoiding animal products may contribute to an increased atherosclerotic risk in these subjects. Recent evidence has suggested that role of hyperhomocysteinemia in atherogenesis is associated with process of autooxidation, which can promote the production of hydroxyl radicals, resulting in oxidative modification of low density lipoprotein and endothelium injury. The oxidant-antioxidant imbalance depends not only on the amount of enhanced free oxygen species but also insufficiency of antioxidant defence system. Total antioxidant status (TAS) expresses capacity for scavenging of free radicals minimizes oxidative damage. The aim of this study was to asses concentrations of homocysteine and total antioxidant status in serum of children on vegetarian and omnivorous diet. We also studied levels of vitamin A (retinol) and vitamin E (alpha-tocopherol) particular components of TAS. MATERIAL AND METHODS: The study included 35 children, aged 5-16 who had been referred to Institute of Mother and Child for dietary consultation. From those, 17 were lacto-ovo-vegetarians and 18 omnivores. Dietary constituents were analyzed using the nutritional programme Dietetyk2 and completed with supplementation data. Concentration of homocysteine was estimated in serum with fluorescence polarization immunoassay and TAS by colorimetric method. Levels of vitamin A and E were determined using high-pressure liquid chromatography (HPLC). RESULTS: The mean concentration of homocysteine was similar in both studied groups (vegetarians: 6.13 +/- 1.01 micromol/l vs. omnivores: 5.45 +/- 0.98 micromol/l). In vegetarian children serum level of TAS was significantly lower (1.21 +/- 0.06 mmol/I) as compared to those in non-vegetarian ones (1.30 +/- 0.05 mmol/l, p < 0.0001), but remained within the physiological range (1.16-1.40 mmol/l). The mean concentrations of vitamins A and E in serum of vegetarians were lower than observed in omnivores group, but only in case of alpha-tocopherol the difference was statistically significant (vegetarians: 15.58 +/- 4.12 vs. omnivores: 18.41 +/- 3.10; p < 0.05). CONCLUSION: In studied group of children on lacto-ovo-vegetarian diet, serum concentrations of homocysteine are normal and daily food intake of antioxidants and their level in blood are sufficient for preserving adequate total antioxidant status.

[The effect of tobacco smoking during pregnancy on birth mass on the basis of population studies--preliminary results]. / Wplyw palenia tytoniu przez kobiety ciezarne na mase urodzeniowa dzieci w oparciu o badania populacyjne--doniesienie wstepne.

It is commonly known, that tobacco smoking during pregnancy has negative influence on child birth mass. Also in polish population neonates of smoking mothers are frequently born with lower body mass and are smaller. Purpose of this study was to estimate the percentage of women smoking during pregnancy and its relation to body mass of newborns. Research was made on the basis of standardized survey questionnaire done in the group of 20320 mothers. Women were divided into non-smoking and smoking before conception and during pregnancy. Questions concerned also intensity of smoking and body mass of a child. Among of participants 41.5% were in smokers group with tendency to decrease in the course of pregnancy. However even in 3-rd trimester percentage of smoking mothers was high. Body mass of newborns of smokers was lower than in group of abstinent and was related to intensity of smoking. In the light of these results some more intensive prophylactic and education actions are needed.

[The effect of tobacco smoking on serum concentration of IGF-I and its binding proteins IGFBP-3 and IGFBP-4 in pregnant women]. / Wplyw palenia tytoniu na stezenia IGF-I oraz jego bialek wiazacych IGFBP-3 i GFBP-4 w surowicy krwi kobiet ciezarnych.

However smoking during pregnancy has been show to result in growth restriction of the fetus but the mechanism by which this occurs has not been adequately clarified. Insulinlike growth factor (IGF) and its insulin-like growth factor binding protein (IGFBP) are the main mediators of intrauterine fetal growth. The aim of the study was to estimate the effect of tobacco smoking on serum concentrations of IGF-I, IGFBP-3 and IGFBP-4 in pregnant women. Forty five healthy pregnant women patients of Clinical Department of Obstetrics and Gynecology, Institute of Mother and Child, were divided into two groups: smoking and tobacco abstinent according to questionnaire declaration and 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. Serum concentrations of cotinine, IGF-I, IGFBP-3 and IGFBP-4 were determined by immunoenzymatic method. We observed, that in group of smoking mothers the mean serum concentration of cotinine was 82.9 microg/l and correlated positively with number of cigarettes daily consumed (r = 0.47; p < 0.05). In group of tobacco abstinent cotinine in serum was present only in trace amount (range: 0-3.5 microg/l). The mean serum concentration of IGF-I was significantly lower in group of smokers than in non-smoking ones (222,4 microg/L vs 282,1 microg/L; p < 0.05). In tobacco abstinent group we observed positive correlation between gestational age and serum level of IGF-I (r = 0.40; p < 0.05). There was no association among this parameters in smoking pregnant women. In serum of cigarette users the mean concentration of IGFBP-3 was slightly higher as compared to those of tobacco abstinent (6798 microg/L vs 6427 microg/L). In this group level of IGFBP-4 was lower by 20% than in non-smoking ones, but the difference was not statistically significant. Our results indicate that tobacco smoking during pregnancy affect in maternal IGF-I and its binding proteins, which may correlate with smaller birth weight. Further studies will be continued in larger group of women in all trimesters of pregnancy and their children to confirm of this association.

[The influence of tobacco smoking on concentration of the pregnancy-associated plasma protein A (PAPP-A) in pregnant women]. / Wplyw palenia tytoniu na stezenie osoczowego bialka ciazowego A (PAPP-A) u kobiet ciezarnych.

This article presents a review of scientific literature concerning adverse effect of tobacco smoking on concentration of the pregnancy-associated plasma protein A (PAPP-A) in pregnant women. PAPP-A is produced in great amounts during pregnancy by the syncytiotrofoblast, but can be also detected in a variety of cell types such as fibroblasts, osteoblasts and vascular smooth muscle cells (VSMC). We describe the structure of PAPP-A and its function as an insulin-like growth factor binding proteins (IGFBPs) protease with a focus on data obtained in tobacco smoking pregnant women. We also discuss the results of studies indicating a correlation between smoking and deficit of PAPP-A in the first trimester of pregnancy. The review summarizes possible mechanisms relating tobacco smoking to the changes of PAPP-A concentration during pregnancy.

[Exposition of pregnant women and their children on toxic effect of lead from tobacco smoke]. / Narazenie kobiet ciezarnych i ich dzieci na toksyczne dzialanie olowiu inhalowanego z dymem tytoniowym.

Presented work is a review of scientific literature regarding mechanisms of adverse effect of lead exposure on pregnancy and child development. The authors discuss lead metabolism in human body and also determine the mechanism of toxic lead effect with a special emphasis placed on its trans-placental transport and the resulting detrimental effects for the fetus. We also discuss the results of studies indicating a correlation between the lead exposition of pregnant women and developmental deficits in the infant.

[Concentrations of serum bone turnover markers in smoking pregnant women and in umbilical cord blood of newborns]. / Stezenia markerów obrotu kostnego w surowicy krwi kobiet ciezarnych palacych tyton oraz w krwi pepowinowej noworodków.

Smoking is proved to be harmful to many aspects of human health. In many papers lower bone mineral density and differences in bone metabolism in patients who smoke were shown. However, little is known about biochemical bone formation and resorption markers in women who smoke during pregnancy as well as in their newborn. The aim of the study was to assess whether the smoking during pregnancy has an effect on the serum levels of bone metabolism markers in maternal and umbilical cord blood. The study consisted of 43 pregnant women under surveillance at the Obstetrics and Gynecology Clinic of the Institute of Mother and Child in Warsaw. They were divided into two groups: smoking (n = 22) and nonsmoking (n = 21) pregnant women. The serum concentration of bone turnover markers (osteocalcin--OC and C-terminal telopeptide of type I collagen--CTX) were determined by immunoenzymatic method in maternal and umbilical cord blood obtained at the time of delivery. In the whole studied group concentration of bone metabolism markers were significantly higher in umbilical cord blood than in maternal blood. In umbilical cord blood mean concentration of osteocalcin was: 70.4 +/- 19.3 ng/ml whereas in maternal serum it was 16.6 +/- 5.8 ng/ml (p < 0.0001). Moreover, the level of the resorption marker CTX was 1.02 +/- 0.28 ng/ml and 0.71 +/- 0.24 ng/ml (p < 0.0001), respectively. In serum of both smoking and non-smoking mothers similar values of osteocalcin (17.9 +/- 7.1 ng/ml versus 15.3 +/- 3.8 ng/ml) and CTX (0.69 +/- 0.21 ng/ml versus 0.64 +/- 0.27 ng/ml) were observed. However, in umbilical cord blood of smokers, the concentration of OC was about 2-fold lower (p < 0.0001), while the CTX level was slightly higher than in the non-smoking group. In both groups significant correlation (p < 0.0001) between concentration of CTX in mothers and their newborns were found. Our results indicate the negative influence of smoking during pregnancy on the fetal's bone formation process. This is reflected in lower osteocalcin level in umbilical cord blood and might be one of the causes of bone metabolism disturbances later during childhood and even in adult life.

[The effect of tobacco smoking on nitric oxide serum concentration in pregnant women and umbilical cord blood]. / Wplyw palenia tytoniu na stezenia tlenku azotu w surowicy krwi kobiet ciezarnych i krwi pepowinowej.

The aim of the study was to estimate the effect of tobacco smoking on serum nitric oxide (NO) concentration in pregnant women and umbilical cord blood and birth weight. We also examined the relation between serum NO and number of cigarettes consumed by mother. Forty healthy pregnant women patients of Clinical Department of Obstetrics and Gynecology, Institute of Mother and Child were divided into two groups: smoking and tobacco abstinent according to questionnaire declaration. The current smokers were defined as those who had smoked 5 cigarettes per day for 2 years before conception and continued smoking during pregnancy. Serum concentrations of nitric oxide were determined by colorimetric method using a commercially available kit Nitric Oxide NonEnzymatic Assay (Oxis International Inc, USA). We observed that the mean concentrations of nitric oxide in serum were similar on the beginning and the end of pregnancy. In group of smoking women these values decreased during pregnancy and were lower 10% in I and 20% in III trimester (p < 0.01) than in tobacco abstinent. In umbilical cord blood of infants born to smoking women level of nitric oxide was slightly lower than in non-smoking ones. In both studied groups the mean concentrations of nitric oxide in umbilical cord blood were higher than these observed in mothers in third trimester (in smoking 46% and in nonsmoking 17% respectively; p < 0.01). In smoking group we observed positive correlation between concentrations of NO in serum of mothers and cord blood of their newborns (r = 0.74; p < 0.01). Our analysis revealed negative correlation between number of cigarettes consumed and serum nitric oxide in smoking women (r = -0.52 in I trimester and r = -0.47; p < 0.05 in III trimester) as well as in their children (r = - 0.35; p < 0.05). Birth weight in infants born of smoking mothers was lower in average by 260 g as compared with non-smoking ones (p < 0.05). Our results indicate that tobacco smoking during pregnancy reduced serum nitric oxide concentrations in mothers and their children and correlated with number of cigarettes daily consumed. In smoking women lower concentrations of NO co-exist with smaller birth weight than in tobacco abstinent which may suggest correlation between these parameters. Further studies will be continued in larger group of matched maternal-cord pairs to confirm of this association.

[Concentrations of pro-hepcidin in serum of pregnant women and in umbilical cord blood]. / Stzenia pro-hepcydyny w surowicy kobiet ciezarnych oraz krwi pepowinowej.

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.

[Concentration of osteoprotegerin, bone formation and resorption markers in patients with phenylketonuria]. / Stezenie osteoprotegeryny oraz markerów kosciotworzenia i resorpcji kosci u chorych na fenyloketonurie.

UNLABELLED: Non-invasive biochemical markers which show global skeletal activity have lately been developed and validated for the assessment of bone formation and bone resorption processes. Among them, osteocalcin (OC) and collagen type I cross-linked C-telopeptide (CTX) are considered to be clinically useful. Recently the novel cytokine osteoprotegerin (OPG), belonging to the tumour necrosis factor receptor family, has been established as an endogenous inhibitor of osteoclastogenesis and resorption processes. Some authors have observed decreased bone mineral density and osteopenia in patients suffering from phenylketonuria (PKU). The aim of the study was to assess osteoprotegerin and some bone formation and resorption markers concentrations in phenylketonuric patients. MATERIAL AND METHODS: We measured OPG, OC and CTX in 112 patients with PKU treated at the Department of Pediatrics of the Institute of Mother and Child in Warsaw. Healthy subjects in the same age range sent to our laboratory for routine analytical control were the reference group. Serum bone metabolism markers were determined by an immunoenzymatic assays. RESULTS: Mean serum level of OPG was significantly lower in PKU patients than in controls: in prepubertal and postpubertal subjects by about 15% and in adolescents by 35% respectively. Serum OC and CTX in prepubertal children with PKU compared to the control group was lower by 20-25%. In adolescents both markers were slightly lower (by about 10%) and in postpubertal subjects OC was lower by 25% and CTX by 15% compared to the age-matched controls. CONCLUSIONS: Our results indicate that in phenylketonuric patients an imbalance between bone formation and degradation processes occurred and they are at risk for osteopenia and osteoporosis in later life.

[The influence of lead on concentration of the pregnancy-associated plasma protein A (PAPP-A) in pregnant women smoking tobacco--preliminary study]. / Wplyw olowiu na stezenie osoczowego bialka ciazowego A (PAPP-A) u kobiet ciezarnych palacych tyton--badania wstepne.

The epidemiology studies conduct in Institute of Mother and Child indicated that in Poland 25-30% women smoke during pregnancy. Lead exposure from cigarette smoke may have a negative effect on transplacental transpire of micronutrients and if coexists with low concentration of pregnancy. associated plasma protein A (PAPP-A) resulting in adverse influence on growth and fetal development. Literature date points, those clinical symptoms of high blood level of lead and insufficiency of PAPP-A are similar. Therefore the aim of the study was to estimate the effect of lead from cigarettes on plasma PAPP-A levels in smoking pregnant women. Healthy, pregnant women (n = 30), patients of Clinical Department of Obstetrics and Gynaecology, Institute of Mother and Child were divided into groups nonsmoking and smoking according to questionnaire declaration. Plasma concentrations of lead were analysed using inductively coupled plasma mass spectrometry (ICP-MS) on spectrometer analyser ICP MS Elan 6100 (Perkin Elmer, Germany). Plasma level of PAPP-A was measured by immunofluorescence method using BRAHMS (Germany) kits on KRYPTOR (BRAHMS, Germany) analyser. We observed that in plasma of smoking pregnant women the concentration of lead was 2.55 microg/l (range: 0.78-14.6 mg/l) and was higher by 30% than in tobacco abstinent (1.78 microg/l; range: 0.0-4.69 microg/l). In group of smoking mothers level of PAPP-A was lower by 20% than in nonsmoking ones (2.80 IU/L; range: 1.3-9.3 IU/L vs 3.2 IU/L. range: 1.7 - 6.8 IU/L). Our results indicate that tobacco smoking during pregnancy affect in maternal blood lead and plasma protein A values. In smoking women lower concentrations of PAPP-A co-exist with higher than in tobacco abstinent level of lead which may suggest correlation between these parameters. Further studies will be continued in larger group of women in all trimesters of pregnancy to confirm of this association.

[The effect of tobacco smoking during pregnancy on concentration of pro-hepcidin and some parameters of iron metabolism in matched-maternal cord pairs]. / Wplyw palenia tytoniu przez kobiety ciezarne na stezenia pro-hepcydyny i wybrane parametry metabolizmu zelaza we krwi matki i we krwi pepowinowej noworodka.

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.

[Effect of maternal smoking on concentrations of the pregnancy-associated plasma protein A (PAPP-A) and free beta subunit of chorionic gonadotropin (beta hCG) in the first trimester of pregnancy]. / Wplyw palenia tytoniu na stezenie osoczowego bialka ciazowego A (PAPP-A) i wolnej podjednostki beta gonadotropiny kosmówkowej (beta hCG) u kobiet w pierwszym trymestrze ciazy.

A combination of maternal serum levels of free beta human chorionic gonadotropin (free beta hCG) and pregnancy-associated plasma protein-A (PAPP-A) and fetal nuchal transluency thickness (fetal NT) has been shown to be an effective approach to screening for fetal trisomies in the first trimestr of pregnancy. A maternal smoking habit is known to influence these serum markers in singleton pregnancies however it has not been yet completely explained. The aim of this study was the investigation of PAPP-A and beta hCG concentrations in smoking women in the first trimester of pregnancy. The study comprised 215 women between 11th and 14th weeks of gestation: 135 cigarette smokers (age range 19-43 years) and 80 nonsmokers (age range 21-42 years). Only normal singleton pregnancies were included. Smoking women were divided into two groups: 75 women smoking during all along the first trimester and 60 women, who stopped smoking before 6 week of gestation. Maternal serum levels of PAPP-A and beta hCG were measured with the KRYPTOR rapid random-access immunoassay analyser (Brahms GmbH, Germany) using time-resolved amplified cryptate emission technology (TRACE). Combinated fetal nuchal translucency (NT), maternal age and biochemical risk estimates were calculated using the Fetal Medicine Foundation risk algorithm. We observed the lower of PAPP-A median values in both smoking groups by about 20% than in nonsmokers (0.86 MoM; 0.84 MoM versus 1.04 MoM; p < 0.01). We also indicated the lower values of beta hCG in smoking women in comparison to the nonsmoking controls, but this difference was not statistically significant. The concentrations of PAPP-A as well as beta hCG were similar in both groups of smoking women. Further studies will be continued to assessment of smoking influence before conception on maternal serum PAPP-A and beta hCG in the first trimester of pregnancy.

[Concentration of ferritin, transferrin and iron as a markers of iron deficiency in healthy women in reproductive age]. / Stezenia ferytyny, transferyny i zelaza w ocenie niedoborów tego pierwiastka u zdrowych kobiet w wieku reprodukcyjnym.

UNLABELLED: Iron deficiency anemia in pregnancy continues to be a clinical problem, which contributes to maternal and fetal morbidity. Iron store deficiency leads to iron deficient erythropoiesis and to negative iron balance when the iron supply is insufficient to maintain normal concentration of hemoglobin. The aim of this study was aimed to establish concentration of ferritin, transferrin and iron as a markers of iron deficiency in healthy women in reproductive age came for control examination to Institute of Mother and Child in Warsaw. MATERIAL AND METHODS: In serum of 108 healthy, multiparas in age up to 40 years from urban agglomerations, middle-class non-pregnant women concentration of iron, ferritin, transferrin and transferrin saturation were determined by commercially available kits (Hoffman-La Roche, Switzerland). RESULTS: Mean concentration of iron, ferritin and transferrin were among normal values. Low level of iron (below 49 microg/dl) was observed in serum of 12%, this of ferritin (below 20 ng/ml) in 22% and of transferrin (below 252 mg/dl) in 15% of studied women. Transferrin saturation lower than 15% was observed in 9 patients. The obtained values were age dependent. The lowest values of total iron were observed in the youngest group I (below 25 years old) and were accompanied with ferritin level below 20 ng/ml in 26% of women. Low ferritin values were also observed in serum of 22% patients of group II (25-35 years old) and only in 14% of women older than 35 years (group III). Saturation of transferrin lower than 15%, which indicated deficiency of iron for erythropoiesis, was observed in 26%, 13% and 19% patients of group I, II and III respectively. CONCLUSIONS: Obtained results indicated that in population of studied women in reproductive age, subclinical iron deficiency in 20% and negative iron balance in 10% could be observed. Therefore, iron status, especially store ferritin, should be assessed very carefully as a component of medical care.

[The effect of tobacco smoking during pregnancy on concentration of uric acid in matched-maternal cord pairs]. / Wplyw palenia tytoniu przez kobiety ciezarne na stezenie kwasu moczowego we krwi matki i we krwi pepowinowej noworodka.

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.

[Serum folate and homocysteine concentrations in women smoking during pregnancy and in umbilical cord blood of newborns]. / Stezenie kwasu foliowego i homocysteiny w surowicy krwi kobiet palacych tyton podczas ciazy oraz w krwi pepowinowej noworodków.

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.

[The concentration of the pregnancy-associated plasma protein A (PAPP-A) in pregnant women smoking tobacco--preliminary study]. / Stezenie osoczowego bialka ciazowego A (PAPP-A) u ciezarnych kobiet palacych tyton--badania wstepne.

An improvement in prenatal screening for chromosomal defects in the first trimester of pregnancy has been achieved by combining sonography and biochemical markers. Among these markers exist the metalloproteinase pregnancy-associated plasma protein-A (PAPP-A) which promotes cell growth by proteolytic cleavage of insulin-like growth factor binding proteins (IGFBPs) causing the release of IGFs. The reduced level of PAPP-A in smokers in first-trimester has been reported previously. However, smoking influence on maternal level of PAPP-A during pregnancy has not been completely determined. The aim of this preliminary study was the investigation of PAPP-A concentrations in smoking women in the first- and third-trimester of pregnancy. The study comprised 40 pregnant women: 20 nonsmokers and 20 cigarette smokers. Only normal singleton pregnancies were included. Maternal serum levels of PAPP-A were measured with the KRYPTOR rapid random-access immunoassay analyser (Brahms GmbH, Germany) using time-resolved amplified cryptate emission technology (TRACE). In first-trimester of pregnancy we observed the lower of PAPP-A median values in smokers (2.77 IU/L, range 1.12-9.28 IU/L) by 24% than in nonsmokers (3.64 IU/L, range 1.68-6.79 IU/L). Next, we indicated that in third-trimester of pregnancy the PAPP-A median values were lower in smokers (48.45 IU/L, range 15.18-176.2 IU/L) until by 50% in comparison to the controls (96.56 IU/L, range 25.59-164.0 IU/L). Further studies will be continued to assessment the influence of some components from tobacco smoke on maternal serum PAPP-A in all trimesters of pregnancy.

[The effect of tobacco smoking during pregnancy on concentration of vitamin E in blood of mothers and their newborns in umbilical cord blood]. / Wplyw palenia tytoniu w przebiegu ciazy na stezenie witaminy E we krwi matki i we krwi pepowinowej noworodka.

OBJECTIVES: Cigarette smoking during pregnancy generates free radicals and has been implicated in oxidative cellular damage. Vitamin E is natural factor protecting cells from damaging influence of free oxygen species. DESIGN: The aim of the study was to estimate the effect of tobacco smoking during pregnancy on concentration of vitamin E 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 the concentration of cotinine in serum and urine. Level of vitamin E was measured by HPLC (high pressure liquid chromatography) method in plasma and erythrocytes of mothers and umbilical cord blood. RESULTS: We observed that, in group of women smoking during pregnancy concentration of vitamin E was lower in plasma and in erythrocytes as compared with group of non-smoking women. Also in cord blood of newborns of smoking mothers level of vitamin E was significantly lower in plasma (p < 0.01) as well as in erythrocytes (p < 0.0001) than in control group. CONCLUSION: Reduced concentration of plasma and erythrocytes vitamin E during pregnancy suggest that consumption of this antioxidant for neutralization of free radicals present in cigarette smoking is enhanced.