Componentes oxidantes e antioxidantes no colostro e leite materno maduro de mães de recém-nascidos prematuros e de termo: efeito da pré-eclâmpsia
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2021-05-25
Autores
Freitas, Natália Alves de
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Universidade Estadual Paulista (Unesp)
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INTRODUÇÃO: Estresse oxidativo participa na patogênese da pré-eclâmpsia (PE). A composição oxidante e antioxidante do leite materno na PE é pouco conhecida. OBJETIVO: Investigar o efeito da PE na composição oxidante e antioxidante do colostro e leite maduro. MÉTODO: Estudo longitudinal de corte transversal, com puérperas da Maternidade da Faculdade de Medicina de Botucatu – UNESP, no período de 2015-2017. Foram estudadas 300 puérperas, divididas em 2 grupos, pareados pela idade gestacional: PE (n=150) e normotensas (n=150). Colostro foi coletado entre 24-72 horas pós-parto e o leite maduro no final do primeiro mês. Foram dosadas enzimas antioxidantes: Glutationa peroxidase (GPx), Catalase (CAT) e Superóxido dismutase (SOD) e o marcador de peroxidação lipídica malondialdeído (MDA). Os grupos foram comparados pelo Qui-quadrado ou teste Exato de Fisher, ANOVA seguida pelo teste de Wald com controle de confundidores. RESULTADOS: No grupo PE, comparado ao controle, foram detectadas maiores concentrações das enzimas antioxidantes SOD(U/mL) (0,05±0,04 vs 0,04±0,03) e CAT(nmol/min/mL) (560±677 vs 317±359) no colostro, e menores concentrações de MDA(nmol/mg) tanto no colostro (12±11 vs 17±15) como no leite maduro (22±27 vs 38±68). Com a progressão da lactação houve aumento do MDA e diminuição da enzima CAT em ambos os grupos. Na PE o efeito protetor antioxidante do colostro foi maior tanto em prematuros como nos termos, em comparação às normotensas. CONCLUSÃO: Na pré-eclâmpsia a composição oxidante/antioxidante do leite materno modifica-se, principalmente no colostro, com menor conteúdo oxidante e maior concentração de antioxidantes, o que pode beneficiar os recém-nascidos, especialmente os prematuros.
BACKGROUND: Oxidative stress contributes to the pathogenesis of preeclampsia (PE). The oxidant and antioxidant composition of breast milk in PE is not widely known. OBJECTIVE: To investigate the effect of PE on the oxidant and antioxidant composition of colostrum and mature milk. METHOD: Longitudinal cross-sectional study, with puerperal women from the Maternity Hospital of Faculdade de Medicina de Botucatu - UNESP, in the period 2015-2017. Were studied 300 puerperal women, divided into 2 groups, matched by gestational age: PE (n=150) and normotensive (n=150). The colostrum was obtained between 24-72 hours postpartum and mature milk at the end of the first month. Antioxidant enzymes: Glutathione peroxidase (GPx), Catalase (CAT) and Superoxide dismutase (SOD), and the lipid peroxidation marker malondialdehyde (MDA) were assessed. The groups were compared using the Chi-square or Fisher's Exact test, ANOVA followed by the Wald test with confounding control. RESULTS: PE group, compared to the control group, showed higher concentrations of antioxidant enzymes SOD (U/mL) (0.05±0.04 vs 0.04±0.03) and CAT (nmol/min/mL) (560±677 vs 317±359) in the colostrum, and lower concentrations of MDA (nmol/mg) both in colostrum (12±11 vs 17±15) and mature milk (22±27 vs 38±68). As lactation progressed, there was an increase in MDA and a decrease in the CAT concentration in both groups. In PE, the antioxidant protective effect of colostrum was greater in premature and term gestation, compared to normotensive women. CONCLUSION: In pre-eclampsia, the oxidant/antioxidant composition of breast milk is modified, especially in colostrum, with a lower oxidant content and a higher concentration of antioxidants enzymes, which can benefit newborns, especially premature infants.
BACKGROUND: Oxidative stress contributes to the pathogenesis of preeclampsia (PE). The oxidant and antioxidant composition of breast milk in PE is not widely known. OBJECTIVE: To investigate the effect of PE on the oxidant and antioxidant composition of colostrum and mature milk. METHOD: Longitudinal cross-sectional study, with puerperal women from the Maternity Hospital of Faculdade de Medicina de Botucatu - UNESP, in the period 2015-2017. Were studied 300 puerperal women, divided into 2 groups, matched by gestational age: PE (n=150) and normotensive (n=150). The colostrum was obtained between 24-72 hours postpartum and mature milk at the end of the first month. Antioxidant enzymes: Glutathione peroxidase (GPx), Catalase (CAT) and Superoxide dismutase (SOD), and the lipid peroxidation marker malondialdehyde (MDA) were assessed. The groups were compared using the Chi-square or Fisher's Exact test, ANOVA followed by the Wald test with confounding control. RESULTS: PE group, compared to the control group, showed higher concentrations of antioxidant enzymes SOD (U/mL) (0.05±0.04 vs 0.04±0.03) and CAT (nmol/min/mL) (560±677 vs 317±359) in the colostrum, and lower concentrations of MDA (nmol/mg) both in colostrum (12±11 vs 17±15) and mature milk (22±27 vs 38±68). As lactation progressed, there was an increase in MDA and a decrease in the CAT concentration in both groups. In PE, the antioxidant protective effect of colostrum was greater in premature and term gestation, compared to normotensive women. CONCLUSION: In pre-eclampsia, the oxidant/antioxidant composition of breast milk is modified, especially in colostrum, with a lower oxidant content and a higher concentration of antioxidants enzymes, which can benefit newborns, especially premature infants.
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Pré-eclâmpsia, Leite materno, Colostro, Oxidantes, Antioxidantes, Pre-eclampsia, Breast milk, Colostrum, Oxidants, Antioxidants