{"paper_id":"4d80cb72-7a0c-464c-b4b6-5e0a2408273f","body_text":"Does COVID-19 Affect Oxidative and Antioxidant Levels in COVID-19 Positive Mothers and Their Newborns? A Comparative Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Does COVID-19 Affect Oxidative and Antioxidant Levels in COVID-19 Positive Mothers and Their Newborns? A Comparative Study Dilek Kahvecioğlu, Burcu Ceylan Cura Yayla, Salim Neşelioğlu, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6121257/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract The COVID-19 pandemic has become a significant health issue due to its impact on pregnancy and the neonatal period. Research indicates that the thiol-disulfide balance in pregnant women with COVID-19 shifts toward oxidation, linked to ischemic processes in the disease's pathogenesis. This study investigates the oxidative and antioxidant levels in newborns of COVID-19-positive mothers, aiming to understand its potential effects on maternal and neonatal health. This single-center prospective study included 35 newborns born to COVID-19-positive mothers (Group 1), 27 healthy control group newborns (Group 2), and 17 COVID-19-positive mothers (Group 3). Native thiol, total thiol, disulfide, disulfide/native thiol, disulfide/total thiol, native/total thiol, and ischemia-modified albumin (IMA) levels were measured in serum samples using spectrophotometric methods. No significant difference in oxidative and antioxidant levels was observed between Groups 1 and 2. However, IMA levels were significantly higher in Group 3 than in Group 1. This study is the first in English literature to evaluate oxidative and antioxidant levels in newborns of COVID-19-positive mothers. Oxidative and antioxidant levels were similar between newborns of COVID-19-positive mothers and controls, but IMA levels were higher in mothers than their infants.\". These findings suggest future research may focus on the biochemical impacts of COVID-19 during pregnancy and neonatal health. Biological sciences/Microbiology Health sciences/Health care Health sciences/Medical research Covid-19 neonate antioxidant levels IMA Introduction The COVID-19 pandemic has created a global health crisis due to its rapid spread and severe respiratory effects [ 1 ]. Pregnancy, characterized by unique physiological and biochemical changes, is a particularly critical period. Investigating COVID-19's effects during pregnancy is essential for healthy pregnancy management and neonatal care. Oxidant and antioxidant balance is important among the biochemical effects of COVID-19 in pregnancy Changes in thiol-disulfide balance and ischemia-modified albumin (IMA) levels are important markers for understanding disease pathophysiology. Ischemia-modified albumin (IMA), a new marker of oxidative stress, measured by the albumin cobalt binding test is a marker whose level increases secondary to ischemia of myocardial and skeletal muscle. In the literature, IMA levels have been investigated in inflammatory diseases such as obesity, asthma, appendicitis, irritable bowel syndrome, and nephrotic syndrome [ 2 , 3 ]. IMA has additionally been evaluated in infectious diseases such as bacteremia, neonatal sepsis, and pneumonia [ 4 , 5 ]. In addition, low thiol and high IMA levels were found to be associated with disease severity and mortality in patients with COVID-19 [ 6 , 7 ]. However, there are not enough studies in the literature on IMA levels of pregnant women who had COVID-19 during pregnancy. In the context of a SARS-CoV-2 infection, a state of oxidative stress emerges, marked by an increase in lipid peroxidation products and a decrease in glutathione peroxidase activity in newborns. Further research has demonstrated an increase in oxidative stress biomarkers in studies conducted on pediatric and adult patients with confirmed cases of SARS-CoV-2 [ 8 , 9 ] However, there is no study investigating whether oxidant-antioxidant levels are affected in the infants of pregnant women who had COVID-19 during pregnancy and the effects of this situation on the health of the newborn baby. In this study, we sought to evaluate the oxidant and antioxidant parameters and IMA levels in mothers with confirmed cases of the disease and their infants, and to reveal the effects of these biochemical parameters on the health of pregnant women and newborns. Results The study included three groups: 35 babies born to mothers with confirmed SARS-CoV-2 infections (Group 1), 27 healthy control group newborn babies (Group 2), and 17 mothers with confirmed SARS-CoV-2 infections (Group 3). When groups 1 and 2 were compared in terms of demographics, it was found that gestational age and 1st minute APGAR score were higher in group 2. Group 2 also had a higher incidence of delivery with NSVD (Table 1 ). Table 1 Demographic Data of the Groups Group 1 (n: 35) Group 2 (n:27) p Gender (n,%) Girl Boy 13(37.1) 22(62.9) 12 (44.4) 15 (55.6) 0.56 Birth weight & 3245 (1710–4365) 3310 (2580–4125) 0.69 Gestational age 39 (31–41) 39 (38–42) 0.002 AGA (n,%) SGA LGA 30(85.7) 3 (8.5) 2(5.8) 26 (96.3) 0 1 (3.7) 0.41 Head circumference& 35 (28.5–38) 34 ( 32–37) 0.057 Lenght& 51 (41–55) 52 (39–54) 0.77 Birth Type(n,%) NSVD C/S 21(60) 14(40) 22 (81.5) 5 (18.5) 0.03 APGAR 1 min& 8 (6–9) 9 (8–9) 0.006 APGAR 5 min& 9(8–10) 10 (8–10) 0.08 Mother age & 26(17–47) 25 (17–37) 0.48 Gravida& 2 (1–8) 3 (1–8) 0.29 & Median (min-max), NSVD: normal spontaneous vaginal delivery, C/S: cesarean section SGA: small for gestational age LGA: large for gestational age AGA: appropriate for gestational age No significant difference was found between Group 1 and Group 2 in oxidant and antioxidant parameters (native thiol, total thiol, disulfide levels) (Table 2 ). IMA levels were significantly higher in Group 3 compared to Group 1 and Group 2 (p < 0.05) (Table 2 ). Table 2 Oxidant and antioxidant parameters of groups Group 1 (n: 35) Group 2 (n:27) Group 3 (n:17) p Native Thiol (µmol/L) & 352.8 (53.8-579.3) 371.1 (68-562.8) 326.4 (214-418.3) 0.17 Total Thiol (µmol/L) & 390.8(66.3-621.8) 423.8 (87.9-601.5) 367 (275–458) 0.20 Disülfide (µmol/L) & 17.2 (1.7–33.8) 19.7 (5-37.7) 20 (15.2–32.1) 0.32 Disülfide / native Thiol *100& 5.03 (0.51–863) 5.1 (2.3–15.2) 6.3(3.8–14.4) 0.18 Disülfide/ total tiyol *100& 4.57 (0.51–9.9) 4.6 (2.2–11.6) 5.6 (3.5–11.2) 0.17 Native Thiol / total thiol *100& 90.8 (80.7–98.9) 90.7 (76.6–95.4) 88.7 (77.6–92.9) 0.17 IMA (ABSU) & 0.93 (0.7–1.1) 0.95 (0.8–1.1) 0.98 (0.8–1.1) 0.002 IMA: ischemia modified albumin, ABSU: Absorbance units &Median (min-max) Discussion As a result of our study, although there was no significant difference in oxidant and antioxidant parameters between infants of COVID-19 positive mothers and control group infants, especially IMA levels were found to be higher in mothers with COVID-19 compared to their infants. However, other studies in the literature have emphasized that COVID-19 affects oxidative stress markers and the potential effects of this condition on both mother and fetus during pregnancy. Notably, a study by Rychkova et al. with newborns with confirmed cases of the disease noted increased lipid peroxidation products and decreased glutathione peroxidase activity, suggesting that the disease leads to significant changes in oxidative stress responses. Furthermore, the increase in superoxide dismutase activity and elevated retinol levels suggest that the antioxidant defense systems of newborns are activated [ 10 ]. In a study by Rolfo et al. on placental oxidant and antioxidant levels in pregnant women with COVID-19, they found that SARS-CoV-2 infection in the third trimester of pregnancy led to placental mitochondrial changes, an increase in lipid peroxidation products, and an antioxidant adaptation to minimize the negative effects of COVID-19-induced oxidative stress on fetal development [ 11 ]. In our study, we may not have detected a difference in oxidant and antioxidant levels between infants of mothers who had COVID-19 and the control group due to these adaptation mechanisms. Since there are no studies on the infants of mothers who had COVID-19, our study may suggest that COVID-19 infection, especially at birth, does not significantly affect the oxidant and antioxidant levels of infants. However, this finding should be supported by further studies, especially with larger samples. The increase in IMA levels is one of the most remarkable findings of this study. According to the literature, IMA increases in conditions where ischemia and oxidative stress are prominent. It has been shown to increase as a result of tissue hypoxia, especially in neonates with hypoxic ischemic encephalopathy [ 12 , 13 ]. In addition, a positive correlation was found between clinical severity and IMA levels in diseases such as transient tachypnea of the newborn [ 14 ]. In COVID-19 infection, Acar et al. reported that IMA levels increased in patients with severe COVID-19 pneumonia and this was associated with disease severity [ 6 ]. In a study conducted by Öncel et al. in children, IMA levels were statistically significantly higher in moderate-severe clinical cases. They stated that it is a new marker that can be used in the diagnosis of COVID-19 infection [ 15 ]. The high levels of IMA in the mothers with positive cases of the novel corona virus in our study align with the findings of other studies. The present study is notable for its consideration of the oxidant and antioxidant levels of newborns whose mothers are infected with SARS-CoV-2, a condition that has not been previously examined in the English medical literature. It represents a significant contribution to the existing knowledge base by investigating the effects of this condition on maternal and neonatal health. The study also supports the existing literature on the use of IMA levels as a biochemical marker in patients with SARS-CoV-2. However, the study is not without limitations. The relatively limited number of participants may have constrained the study's statistical power, and the absence of long-term follow-up data from the patients precluded the evaluation of potential long-term effects of the disease on newborns. Furthermore, the study did not fully elucidate the impact of variables such as maternal nutritional status and environmental factors on the variation in oxidant and antioxidant levels of newborns. In conclusion, this study is among the first to examine the oxidant and antioxidant levels of newborns whose mothers have tested positive for SARS-CoV-2. The findings suggest that the biochemical levels of newborns are not affected; however, increased IMA levels in mothers may serve as a significant marker for understanding the effects of SARS-CoV-2 in pregnancy. To further elucidate these findings, it is imperative to expand the sample size and conduct longitudinal studies that delve into the biochemical mechanisms underlying the metabolic adaptation process of newborns. Methods This study was carried out as a single-center prospective study between January 2020 and January 2022 in Ankara Training and Research Hospital, Neonatal Intensive Care Unit and Gynecology- Obstetrics Clinic. Written informed consent was obtained from the participants during the study. The study was approved by the Ethics Committee of the University of Health Science, Ankara Training and Research Hospital (Ankara, Turkey) and was conducted according to the Declaration of Helsinki. (Ethics Committee Number: 03.2024-E-23-1243) The study included three groups: 35 babies born to mothers with confirmed SARS-CoV-2 infections (Group 1), 27 healthy control group newborn babies (Group 2), and 17 mothers with confirmed SARS-CoV-2 infections (Group 3). The study group (Group 1) consisted of newborns born to mothers with positive SARS-CoV-2 PCRs taken for routine screening during hospital admissions with negative PCRs and no clinical suspicion. The healthy control group consisted of newborns who were being followed up by their mothers and whose mothers and newborns themselves were SARS COV-2 PCR negative and had no comorbidities (group-2). In addition, PCR positive mothers were included in the study as group 3. Newborns with positive SARS COV-2 PCR and patients who refused to participate in the study were excluded from the study. Detection of SARS CoV-2 RNA in the nasopharyngeal swabs was performed according to the manufacturer's instructions by using a commercial RT‐PCR (The Bio‐Speedy Direct RT‐qPCR SARS CoV‐2 nucleic acid detection kit, Bioeksen, Turkey). One cc blood sample was collected from each participant. The serum was then subjected to centrifugation and stored at -80°C. Levels of native thiol, total thiol, disulfide, and ischemia-modified albumin (IMA) were subsequently determined. Total serum oxidant and total antioxidant levels were measured with a spectrophotometer called Roche Cobas C501 automatic analyzer and a new automated colorimetric method developed by Erel. Ischemia-modified albumin level measurement was measured with the colorimetric method defined by Bar-Or et al. Thiol-disulfide balance tests were measured using the automatic colorimetric \"Modified Ellman Method\" defined by Erel et al. Statistical analysis was performed using IBM SPSS Statistics 22 (Statistical Package for Social Sciences, IBM Inc., Chicago, IL, USA). Histogram, Skewness and Kurtosis values were used in addition to Kolmogorov-Smirnov test for normality distribution. Chi-square was used to compare categorical groups. In correlation evaluation, Pearson correlation for normal distribution values and Spearman correlation for those without normal distribution values were performed. Independent Samples T-Test was used to compare the averages of two independent groups with normal distribution and Mann Whitney U test was used to compare the median of two independent groups with no normal distribution. Significance level was accepted if p-value was less than 0.05 (p < 0.05). Declarations Author Contribution “Conceptualization, D.K, B.C.C; methodology, D.K, B.C.C; formal analysis, S.N, Ö.E.; investi-gation S.N, Ö.E.; resources,. D.K, B.C.C; S.N, Ö.E; data curation, D.K, B.C.C; S.N, Ö.E.; writ-ing—original draft preparation D.K, B.C.C.; writing—review and editing, D.K, B.C.C;; supervi-sion D.K. All authors have read and agreed to the published version of the manuscript.” Data Availability Availability of data and materialsThe data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request. Data are located in controlled access data storage at University of Health Sciences in Ankara. References Lu Q, Shi Y Coronavirus disease (COVID-19) and neonate: What neonatologist need to know. J Med Virol. 92 (6):564-567(2020). Mehmetoğlu I, et al. Obesity is an independent determinant of ischemia-modified albumin Obes Facts. 5 (5):700-709. (2012). Durankuş F, Şenkal E, Çam S. et al. Altered thiol/disulfide homeostasis and ischemia-modified albumin levels in children with irritable bowel syndrome. Pediatr Int. 63 (3):300-305. (2021). Yerlikaya FH et al. Serum ischemia-modified albumin levels at diagnosis and during treatment of late-onset neonatal sepsis. J Matern Fetal Neonatal Med. 27 (17):1723-7.(2014). Bolatkale M, et al. A novel biochemical marker for community-acquired pneumonia: Ischemia-modified albumin. Am J Emerg Med 35 (8):1121-1125. (2017). Acar T, Ertekin B, Yortanli M. Value of thiol and ischemia modified albumin (IMA) in predicting mortality in serious COVID-19 pneumonia. Heliyon .8 (12):e12514. (2022). Yucel K, Fuat Gurbuz A. Hypoxia-inducible factor-1α and ischemia-modified albumin levels in intensive care COVID-19 Patients. Horm Mol Biol Clin Investig. 43 (4):415-420. (2022). Aykac K et al. Oxidant and antioxidant balance in patients with COVID-19. Pediatr Pulmonol. 56 (9):2803-2810. (2021). Çakırca G,et al. Thiol level and total oxidant/antioxidant status in patients with COVID-19 infection. Ir J Med Sci. 191 (4):1925-1930. (2022). Rychkova LV, et al. Pro-and Antioxidant Status in Newborn with COVID-19. Bull Exp Biol Med. 174 (4):464-467. (2023). Rolfo A, et al. Increased Placental Anti-Oxidant Response in Asymptomatic and Symptomatic COVID-19 Third-Trimester Pregnancies. Biomedicines. 10 (3):634(2022). Dursun A, Okumus N, Zenciroglu A.). Ischemia-modified albumin (IMA): could it be useful to predict perinatal asphyxia? J Matern Fetal Neonatal Med. 25( 11):2401-2405. (2012) Delsuz SF, Ischemia-Modified Albumin and Antioxidant Protection in Newborns with Asphyxia of Varying Severity. Bull Exp Biol Med.; 175 (5):620-624. (2023). Oztekın O, et al. Levels of ischemia-modified albumin in transient tachypnea of the newborn. Am J Perinatol. 30 (2):193-8(2015). Öncel EK,et al. Evaluation of ischemia-modified albumin in the diagnosis and the clinical severity of COVID-19 in children. Turk J Pediatr. 65 (3):425-432. (2023). Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-6121257\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Article\",\"associatedPublications\":[],\"authors\":[{\"id\":423256853,\"identity\":\"22e27286-de7b-4afb-b244-d10444765602\",\"order_by\":0,\"name\":\"Dilek Kahvecioğlu\",\"email\":\"data:image/png;base64,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\",\"orcid\":\"\",\"institution\":\"University of Health Sciences, Ankara Training and Research Hospital, Department of Neonatology\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"Dilek\",\"middleName\":\"\",\"lastName\":\"Kahvecioğlu\",\"suffix\":\"\"},{\"id\":423256854,\"identity\":\"0cdbfb55-22c4-462b-a228-aa6f9d973771\",\"order_by\":1,\"name\":\"Burcu Ceylan Cura Yayla\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"University of Health Sciences, Ankara Training and Research Hospital, Pediatric Infection,\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Burcu\",\"middleName\":\"Ceylan Cura\",\"lastName\":\"Yayla\",\"suffix\":\"\"},{\"id\":423256855,\"identity\":\"3f217674-ac7a-487e-ace1-da3d0eace6e7\",\"order_by\":2,\"name\":\"Salim Neşelioğlu\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Yildirim Beyazit University, Faculty of Medicine, Department of Medical Biochemistry, Ankara, Turkey\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Salim\",\"middleName\":\"\",\"lastName\":\"Neşelioğlu\",\"suffix\":\"\"},{\"id\":423256856,\"identity\":\"8e8d7f8e-ae5c-42dc-896a-3f7b7f766711\",\"order_by\":3,\"name\":\"Özcan Erel\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Yildirim Beyazit University, Faculty of Medicine, Department of Medical Biochemistry, Ankara, Turkey\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Özcan\",\"middleName\":\"\",\"lastName\":\"Erel\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2025-02-27 13:08:33\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-6121257/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-6121257/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":80874062,\"identity\":\"9c50191f-fcf0-4935-849c-a3ba4004815c\",\"added_by\":\"auto\",\"created_at\":\"2025-04-18 06:02:37\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":385935,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-6121257/v1/f5e85eda-8540-43fb-a23b-87b6e133d548.pdf\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Does COVID-19 Affect Oxidative and Antioxidant Levels in COVID-19 Positive Mothers and Their Newborns? A Comparative Study\",\"fulltext\":[{\"header\":\"Introduction\",\"content\":\"\\u003cp\\u003eThe COVID-19 pandemic has created a global health crisis due to its rapid spread and severe respiratory effects [\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e]. Pregnancy, characterized by unique physiological and biochemical changes, is a particularly critical period. Investigating COVID-19's effects during pregnancy is essential for healthy pregnancy management and neonatal care.\\u003c/p\\u003e \\u003cp\\u003eOxidant and antioxidant balance is important among the biochemical effects of COVID-19 in pregnancy Changes in thiol-disulfide balance and ischemia-modified albumin (IMA) levels are important markers for understanding disease pathophysiology.\\u003c/p\\u003e \\u003cp\\u003eIschemia-modified albumin (IMA), a new marker of oxidative stress, measured by the albumin cobalt binding test is a marker whose level increases secondary to ischemia of myocardial and skeletal muscle. In the literature, IMA levels have been investigated in inflammatory diseases such as obesity, asthma, appendicitis, irritable bowel syndrome, and nephrotic syndrome [\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e]. IMA has additionally been evaluated in infectious diseases such as bacteremia, neonatal sepsis, and pneumonia [\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e]. In addition, low thiol and high IMA levels were found to be associated with disease severity and mortality in patients with COVID-19 [\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e]. However, there are not enough studies in the literature on IMA levels of pregnant women who had COVID-19 during pregnancy.\\u003c/p\\u003e \\u003cp\\u003eIn the context of a SARS-CoV-2 infection, a state of oxidative stress emerges, marked by an increase in lipid peroxidation products and a decrease in glutathione peroxidase activity in newborns. Further research has demonstrated an increase in oxidative stress biomarkers in studies conducted on pediatric and adult patients with confirmed cases of SARS-CoV-2 [\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e] However, there is no study investigating whether oxidant-antioxidant levels are affected in the infants of pregnant women who had COVID-19 during pregnancy and the effects of this situation on the health of the newborn baby.\\u003c/p\\u003e \\u003cp\\u003eIn this study, we sought to evaluate the oxidant and antioxidant parameters and IMA levels in mothers with confirmed cases of the disease and their infants, and to reveal the effects of these biochemical parameters on the health of pregnant women and newborns.\\u003c/p\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003eThe study included three groups: 35 babies born to mothers with confirmed SARS-CoV-2 infections (Group 1), 27 healthy control group newborn babies (Group 2), and 17 mothers with confirmed SARS-CoV-2 infections (Group 3). When groups 1 and 2 were compared in terms of demographics, it was found that gestational age and 1st minute APGAR score were higher in group 2. Group 2 also had a higher incidence of delivery with NSVD (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eDemographic Data of the Groups\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"4\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eGroup 1 (n: 35)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eGroup 2 (n:27)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ep\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eGender (n,%)\\u003c/p\\u003e \\u003cp\\u003eGirl\\u003c/p\\u003e \\u003cp\\u003eBoy\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e13(37.1)\\u003c/p\\u003e \\u003cp\\u003e22(62.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e12 (44.4)\\u003c/p\\u003e \\u003cp\\u003e15 (55.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.56\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eBirth weight \\u0026amp;\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e3245 (1710\\u0026ndash;4365)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e3310 (2580\\u0026ndash;4125)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.69\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eGestational age\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e39 (31\\u0026ndash;41)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e39 (38\\u0026ndash;42)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.002\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eAGA (n,%)\\u003c/p\\u003e \\u003cp\\u003eSGA\\u003c/p\\u003e \\u003cp\\u003eLGA\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e30(85.7)\\u003c/p\\u003e \\u003cp\\u003e3 (8.5)\\u003c/p\\u003e \\u003cp\\u003e2(5.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e26 (96.3)\\u003c/p\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003cp\\u003e1 (3.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.41\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eHead circumference\\u0026amp;\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e35 (28.5\\u0026ndash;38)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e34 ( 32\\u0026ndash;37)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.057\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eLenght\\u0026amp;\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e51 (41\\u0026ndash;55)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e52 (39\\u0026ndash;54)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.77\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eBirth Type(n,%)\\u003c/p\\u003e \\u003cp\\u003eNSVD\\u003c/p\\u003e \\u003cp\\u003eC/S\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e21(60)\\u003c/p\\u003e \\u003cp\\u003e14(40)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e22 (81.5)\\u003c/p\\u003e \\u003cp\\u003e5 (18.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.03\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eAPGAR 1 min\\u0026amp;\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e8 (6\\u0026ndash;9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e9 (8\\u0026ndash;9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.006\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eAPGAR 5 min\\u0026amp;\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e9(8\\u0026ndash;10)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e10 (8\\u0026ndash;10)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.08\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMother age \\u0026amp;\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e26(17\\u0026ndash;47)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e25 (17\\u0026ndash;37)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.48\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eGravida\\u0026amp;\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e2 (1\\u0026ndash;8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e3 (1\\u0026ndash;8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.29\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003ctfoot\\u003e \\u003ctr\\u003e\\u003ctd colspan=\\\"4\\\"\\u003e\\u0026amp; Median (min-max), NSVD: normal spontaneous vaginal delivery, C/S: cesarean section SGA: small for gestational age LGA: large for gestational age AGA: appropriate for gestational age\\u003c/td\\u003e\\u003c/tr\\u003e \\u003c/tfoot\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003eNo significant difference was found between Group 1 and Group 2 in oxidant and antioxidant parameters (native thiol, total thiol, disulfide levels) (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e). IMA levels were significantly higher in Group 3 compared to Group 1 and Group 2 (p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05) (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab2\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 2\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eOxidant and antioxidant parameters of groups\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"5\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eGroup 1 (n: 35)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eGroup 2 (n:27)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eGroup 3 (n:17)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003ep\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNative Thiol (\\u0026micro;mol/L) \\u0026amp;\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e352.8 (53.8-579.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e371.1 (68-562.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e326.4 (214-418.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.17\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eTotal Thiol (\\u0026micro;mol/L) \\u0026amp;\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e390.8(66.3-621.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e423.8 (87.9-601.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e367 (275\\u0026ndash;458)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.20\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eDis\\u0026uuml;lfide (\\u0026micro;mol/L) \\u0026amp;\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e17.2 (1.7\\u0026ndash;33.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e19.7 (5-37.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e20 (15.2\\u0026ndash;32.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.32\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eDis\\u0026uuml;lfide / native Thiol *100\\u0026amp;\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e5.03 (0.51\\u0026ndash;863)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e5.1 (2.3\\u0026ndash;15.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e6.3(3.8\\u0026ndash;14.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.18\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eDis\\u0026uuml;lfide/ total tiyol *100\\u0026amp;\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e4.57 (0.51\\u0026ndash;9.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e4.6 (2.2\\u0026ndash;11.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e5.6 (3.5\\u0026ndash;11.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.17\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNative Thiol / total thiol *100\\u0026amp;\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e90.8 (80.7\\u0026ndash;98.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e90.7 (76.6\\u0026ndash;95.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e88.7 (77.6\\u0026ndash;92.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.17\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eIMA (ABSU) \\u0026amp;\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.93 (0.7\\u0026ndash;1.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.95 (0.8\\u0026ndash;1.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.98 (0.8\\u0026ndash;1.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.002\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003ctfoot\\u003e \\u003ctr\\u003e\\u003ctd colspan=\\\"5\\\"\\u003eIMA: ischemia modified albumin, ABSU: Absorbance units \\u0026amp;Median (min-max)\\u003c/td\\u003e\\u003c/tr\\u003e \\u003c/tfoot\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eAs a result of our study, although there was no significant difference in oxidant and antioxidant parameters between infants of COVID-19 positive mothers and control group infants, especially IMA levels were found to be higher in mothers with COVID-19 compared to their infants.\\u003c/p\\u003e \\u003cp\\u003eHowever, other studies in the literature have emphasized that COVID-19 affects oxidative stress markers and the potential effects of this condition on both mother and fetus during pregnancy. Notably, a study by Rychkova et al. with newborns with confirmed cases of the disease noted increased lipid peroxidation products and decreased glutathione peroxidase activity, suggesting that the disease leads to significant changes in oxidative stress responses. Furthermore, the increase in superoxide dismutase activity and elevated retinol levels suggest that the antioxidant defense systems of newborns are activated [\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eIn a study by Rolfo et al. on placental oxidant and antioxidant levels in pregnant women with COVID-19, they found that SARS-CoV-2 infection in the third trimester of pregnancy led to placental mitochondrial changes, an increase in lipid peroxidation products, and an antioxidant adaptation to minimize the negative effects of COVID-19-induced oxidative stress on fetal development [\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e]. In our study, we may not have detected a difference in oxidant and antioxidant levels between infants of mothers who had COVID-19 and the control group due to these adaptation mechanisms. Since there are no studies on the infants of mothers who had COVID-19, our study may suggest that COVID-19 infection, especially at birth, does not significantly affect the oxidant and antioxidant levels of infants. However, this finding should be supported by further studies, especially with larger samples.\\u003c/p\\u003e \\u003cp\\u003eThe increase in IMA levels is one of the most remarkable findings of this study. According to the literature, IMA increases in conditions where ischemia and oxidative stress are prominent. It has been shown to increase as a result of tissue hypoxia, especially in neonates with hypoxic ischemic encephalopathy [\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e]. In addition, a positive correlation was found between clinical severity and IMA levels in diseases such as transient tachypnea of the newborn [\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e]. In COVID-19 infection, Acar et al. reported that IMA levels increased in patients with severe COVID-19 pneumonia and this was associated with disease severity [\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e]. In a study conducted by \\u0026Ouml;ncel et al. in children, IMA levels were statistically significantly higher in moderate-severe clinical cases. They stated that it is a new marker that can be used in the diagnosis of COVID-19 infection [\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e]. The high levels of IMA in the mothers with positive cases of the novel corona virus in our study align with the findings of other studies.\\u003c/p\\u003e \\u003cp\\u003eThe present study is notable for its consideration of the oxidant and antioxidant levels of newborns whose mothers are infected with SARS-CoV-2, a condition that has not been previously examined in the English medical literature. It represents a significant contribution to the existing knowledge base by investigating the effects of this condition on maternal and neonatal health. The study also supports the existing literature on the use of IMA levels as a biochemical marker in patients with SARS-CoV-2.\\u003c/p\\u003e \\u003cp\\u003eHowever, the study is not without limitations. The relatively limited number of participants may have constrained the study's statistical power, and the absence of long-term follow-up data from the patients precluded the evaluation of potential long-term effects of the disease on newborns. Furthermore, the study did not fully elucidate the impact of variables such as maternal nutritional status and environmental factors on the variation in oxidant and antioxidant levels of newborns.\\u003c/p\\u003e \\u003cp\\u003eIn conclusion, this study is among the first to examine the oxidant and antioxidant levels of newborns whose mothers have tested positive for SARS-CoV-2. The findings suggest that the biochemical levels of newborns are not affected; however, increased IMA levels in mothers may serve as a significant marker for understanding the effects of SARS-CoV-2 in pregnancy. To further elucidate these findings, it is imperative to expand the sample size and conduct longitudinal studies that delve into the biochemical mechanisms underlying the metabolic adaptation process of newborns.\\u003c/p\\u003e\"},{\"header\":\"Methods\",\"content\":\"\\u003cp\\u003e This study was carried out as a single-center prospective study between January 2020 and January 2022 in Ankara Training and Research Hospital, Neonatal Intensive Care Unit and Gynecology- Obstetrics Clinic. Written informed consent was obtained from the participants during the study. The study was approved by the Ethics Committee of the University of Health Science, Ankara Training and Research Hospital (Ankara, Turkey) and was conducted according to the Declaration of Helsinki. (Ethics Committee Number: 03.2024-E-23-1243)\\u003c/p\\u003e \\u003cp\\u003eThe study included three groups: 35 babies born to mothers with confirmed SARS-CoV-2 infections (Group 1), 27 healthy control group newborn babies (Group 2), and 17 mothers with confirmed SARS-CoV-2 infections (Group 3). The study group (Group 1) consisted of newborns born to mothers with positive SARS-CoV-2 PCRs taken for routine screening during hospital admissions with negative PCRs and no clinical suspicion.\\u003c/p\\u003e \\u003cp\\u003eThe healthy control group consisted of newborns who were being followed up by their mothers and whose mothers and newborns themselves were SARS COV-2 PCR negative and had no comorbidities (group-2). In addition, PCR positive mothers were included in the study as group 3. Newborns with positive SARS COV-2 PCR and patients who refused to participate in the study were excluded from the study.\\u003c/p\\u003e \\u003cp\\u003eDetection of SARS CoV-2 RNA in the nasopharyngeal swabs was performed according to the manufacturer's instructions by using a commercial RT‐PCR (The Bio‐Speedy Direct RT‐qPCR SARS CoV‐2 nucleic acid detection kit, Bioeksen, Turkey).\\u003c/p\\u003e \\u003cp\\u003eOne cc blood sample was collected from each participant. The serum was then subjected to centrifugation and stored at -80\\u0026deg;C. Levels of native thiol, total thiol, disulfide, and ischemia-modified albumin (IMA) were subsequently determined.\\u003c/p\\u003e \\u003cp\\u003eTotal serum oxidant and total antioxidant levels were measured with a spectrophotometer called Roche Cobas C501 automatic analyzer and a new automated colorimetric method developed by Erel.\\u003c/p\\u003e \\u003cp\\u003eIschemia-modified albumin level measurement was measured with the colorimetric method defined by Bar-Or et al. Thiol-disulfide balance tests were measured using the automatic colorimetric \\\"Modified Ellman Method\\\" defined by Erel et al.\\u003c/p\\u003e \\u003cp\\u003eStatistical analysis was performed using IBM SPSS Statistics 22 (Statistical Package for Social Sciences, IBM Inc., Chicago, IL, USA). Histogram, Skewness and Kurtosis values were used in addition to Kolmogorov-Smirnov test for normality distribution. Chi-square was used to compare categorical groups. In correlation evaluation, Pearson correlation for normal distribution values and Spearman correlation for those without normal distribution values were performed. Independent Samples T-Test was used to compare the averages of two independent groups with normal distribution and Mann Whitney U test was used to compare the median of two independent groups with no normal distribution. Significance level was accepted if p-value was less than 0.05 (p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05).\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003ch2\\u003eAuthor Contribution\\u003c/h2\\u003e\\u003cp\\u003e\\u0026ldquo;Conceptualization, D.K, B.C.C; methodology, D.K, B.C.C; formal analysis, S.N, \\u0026Ouml;.E.; investi-gation S.N, \\u0026Ouml;.E.; resources,. D.K, B.C.C; S.N, \\u0026Ouml;.E; data curation, D.K, B.C.C; S.N, \\u0026Ouml;.E.; writ-ing\\u0026mdash;original draft preparation D.K, B.C.C.; writing\\u0026mdash;review and editing, D.K, B.C.C;; supervi-sion D.K. All authors have read and agreed to the published version of the manuscript.\\u0026rdquo;\\u003c/p\\u003e\\u003ch2\\u003eData Availability\\u003c/h2\\u003e\\u003cp\\u003eAvailability of data and materialsThe data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request. Data are located in controlled access data storage at University of Health Sciences in Ankara.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\n\\u003cli\\u003eLu Q, Shi Y Coronavirus disease (COVID-19) and neonate: What neonatologist need to know. J Med Virol. \\u003cstrong\\u003e92\\u003c/strong\\u003e(6):564-567(2020).\\u003c/li\\u003e\\n\\u003cli\\u003eMehmetoğlu I, et al. Obesity is an independent determinant of ischemia-modified albumin Obes Facts. \\u003cstrong\\u003e5\\u003c/strong\\u003e(5):700-709. (2012). \\u003c/li\\u003e\\n\\u003cli\\u003eDurankuş F, Şenkal E, \\u0026Ccedil;am S. et al. Altered thiol/disulfide homeostasis and ischemia-modified albumin levels in children with irritable bowel syndrome. Pediatr Int. \\u003cstrong\\u003e63\\u003c/strong\\u003e(3):300-305. (2021). \\u003c/li\\u003e\\n\\u003cli\\u003eYerlikaya FH et al. Serum ischemia-modified albumin levels at diagnosis and during treatment of late-onset neonatal sepsis. J Matern Fetal Neonatal Med. \\u003cstrong\\u003e27\\u003c/strong\\u003e(17):1723-7.(2014). \\u003c/li\\u003e\\n\\u003cli\\u003eBolatkale M, et al. A novel biochemical marker for community-acquired pneumonia: Ischemia-modified albumin. Am J Emerg Med \\u003cstrong\\u003e35\\u003c/strong\\u003e(8):1121-1125. (2017). \\u003c/li\\u003e\\n\\u003cli\\u003eAcar T, Ertekin B, Yortanli M. Value of thiol and ischemia modified albumin (IMA) in predicting mortality in serious COVID-19 pneumonia. Heliyon\\u003cstrong\\u003e.8\\u003c/strong\\u003e(12):e12514. (2022).\\u003c/li\\u003e\\n\\u003cli\\u003eYucel K, Fuat Gurbuz A. Hypoxia-inducible factor-1\\u0026alpha; and ischemia-modified albumin levels in intensive care COVID-19 Patients. Horm Mol Biol Clin Investig.\\u003cstrong\\u003e 43\\u003c/strong\\u003e(4):415-420. (2022).\\u003c/li\\u003e\\n\\u003cli\\u003eAykac K et al. Oxidant and antioxidant balance in patients with COVID-19. Pediatr Pulmonol. \\u003cstrong\\u003e56\\u003c/strong\\u003e(9):2803-2810. (2021). \\u003c/li\\u003e\\n\\u003cli\\u003e\\u0026Ccedil;akırca G,et al. Thiol level and total oxidant/antioxidant status in patients with COVID-19 infection. Ir J Med Sci.\\u003cstrong\\u003e191\\u003c/strong\\u003e(4):1925-1930. (2022). \\u003c/li\\u003e\\n\\u003cli\\u003eRychkova LV, et al. Pro-and Antioxidant Status in Newborn with COVID-19. Bull Exp Biol Med.\\u003cstrong\\u003e174\\u003c/strong\\u003e(4):464-467. (2023).\\u003c/li\\u003e\\n\\u003cli\\u003eRolfo A, et al. Increased Placental Anti-Oxidant Response in Asymptomatic and Symptomatic COVID-19 Third-Trimester Pregnancies. Biomedicines. \\u003cstrong\\u003e10\\u003c/strong\\u003e(3):634(2022).\\u003c/li\\u003e\\n\\u003cli\\u003eDursun A, Okumus N, Zenciroglu A.). Ischemia-modified albumin (IMA): could it be useful to predict perinatal asphyxia? J Matern Fetal Neonatal Med.\\u003cstrong\\u003e25(\\u003c/strong\\u003e11):2401-2405. (2012)\\u003c/li\\u003e\\n\\u003cli\\u003eDelsuz SF, Ischemia-Modified Albumin and Antioxidant Protection in Newborns with Asphyxia of Varying Severity. Bull Exp Biol Med.;\\u003cstrong\\u003e175\\u003c/strong\\u003e(5):620-624. (2023). \\u003c/li\\u003e\\n\\u003cli\\u003eOztekın O, et al. Levels of ischemia-modified albumin in transient tachypnea of the newborn. Am J Perinatol.\\u003cstrong\\u003e30\\u003c/strong\\u003e(2):193-8(2015).\\u003c/li\\u003e\\n\\u003cli\\u003e\\u0026Ouml;ncel EK,et al. Evaluation of ischemia-modified albumin in the diagnosis and the clinical severity of COVID-19 in children. Turk J Pediatr. \\u003cstrong\\u003e65\\u003c/strong\\u003e(3):425-432. (2023).\\u003c/li\\u003e\\n\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Covid-19, neonate, antioxidant levels, IMA\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-6121257/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-6121257/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003eThe COVID-19 pandemic has become a significant health issue due to its impact on pregnancy and the neonatal period. Research indicates that the thiol-disulfide balance in pregnant women with COVID-19 shifts toward oxidation, linked to ischemic processes in the disease's pathogenesis. This study investigates the oxidative and antioxidant levels in newborns of COVID-19-positive mothers, aiming to understand its potential effects on maternal and neonatal health.\\u003c/p\\u003e \\u003cp\\u003eThis single-center prospective study included 35 newborns born to COVID-19-positive mothers (Group 1), 27 healthy control group newborns (Group 2), and 17 COVID-19-positive mothers (Group 3). Native thiol, total thiol, disulfide, disulfide/native thiol, disulfide/total thiol, native/total thiol, and ischemia-modified albumin (IMA) levels were measured in serum samples using spectrophotometric methods.\\u003c/p\\u003e \\u003cp\\u003eNo significant difference in oxidative and antioxidant levels was observed between Groups 1 and 2. However, IMA levels were significantly higher in Group 3 than in Group 1.\\u003c/p\\u003e \\u003cp\\u003eThis study is the first in English literature to evaluate oxidative and antioxidant levels in newborns of COVID-19-positive mothers. Oxidative and antioxidant levels were similar between newborns of COVID-19-positive mothers and controls, but IMA levels were higher in mothers than their infants.\\\". These findings suggest future research may focus on the biochemical impacts of COVID-19 during pregnancy and neonatal health.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Does COVID-19 Affect Oxidative and Antioxidant Levels in COVID-19 Positive Mothers and Their Newborns? A Comparative Study\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2025-03-05 04:59:38\",\"doi\":\"10.21203/rs.3.rs-6121257/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"bd343e59-2f3b-48fa-99b3-e2bdf8b88767\",\"owner\":[],\"postedDate\":\"March 5th, 2025\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"posted\",\"subjectAreas\":[{\"id\":45105100,\"name\":\"Biological sciences/Microbiology\"},{\"id\":45105101,\"name\":\"Health sciences/Health care\"},{\"id\":45105102,\"name\":\"Health sciences/Medical research\"}],\"tags\":[],\"updatedAt\":\"2025-04-18T05:38:30+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2025-03-05 04:59:38\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-6121257\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-6121257\",\"identity\":\"rs-6121257\",\"version\":[\"v1\"]},\"buildId\":\"XKTyCvWXoU3ODBz1xrDgd\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}