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Vol. 54. Issue 3.
Pages 290-296 (1 March 2001)
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Vol. 54. Issue 3.
Pages 290-296 (1 March 2001)
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Concentraciones de calcio y de marcadores de remodelamiento óseo en sangre de cordón umbilical y en orina del recién nacido en el parto
Concentrations of calcium and bone remodeling biomarkers in umbilical cord blood and urine of newborn infants during delivery
Visits
7106
A. de Toro Salasa,
Corresponding author
med009753@nacom.es

Correspondencia: Ximénez de Enciso, 22, 1.° B. 41004 Sevilla
, J.L. Dueñas Díeza, E. de Jaime Revueltab
a Servicios de Ginecología. Hospital Universitario Virgen de la Macarena. Sevilla
b Servicios de Pediatría. Hospital Universitario Virgen de la Macarena. Sevilla
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Objetivo

Evaluar las concentraciones de calcio, fósforo, paratormona (PTH), osteocalcina y fosfatasa alcalina en sangre de cordón umbilical y de las piridinolinas urinarias junto con el cálculo del cociente piridinolinas/creatinina, con el fin de estimar, indirectamente, el proceso de remodelamiento óseo fetal, comparando los valores de estos marcadores con los obtenidos de la madre durante el parto y el tercer trimestre de gestación

Pacientes y métodos

Se estudiaron los valores séricos de calcio, fósforo,PTH, osteocalcina, fosfatasa alcalina y de piridinolinas en orina, y se procedió al cálculo del cociente piridinolinas/creatinina en 38 gestantes normales durante los últimos 2 meses de gestación y durante el parto. Se obtuvieron muestras de sangre de la vena umbilical durante el período del alumbramiento, y de orina de los mismos recién nacidos en las primeras 24 h puerperales para determinar estos parámetros

Resultados

El valor del calcio en la sangre de cordón fue superior al obtenido en sangre materna durante el parto. Las concentraciones de PTH en sangre de cordón fueron muy inferiores a las obtenidas en sangre materna, las de fosfatasa alcalina fueron similares y las de osteocalcina, superiores.El valor medio de las piridinolinas en orina del recién nacido fue muy superior a los obtenidos en la madre durante el tercer trimestre del embarazo y en el parto

Conclusión

El recién nacido es hipercalcémico respecto a la madreen el momento del parto y presenta un estado de hipoparatiroidismo relativo. En general, los marcadores de remodelamiento óseo presentan unos valores más elevados en el recién nacido que en la madre, mostrando una alta tasa de remodelamiento óseo

Palabras clave:
Osteocalcina
Piridinolinas
Gestación
Parto
Cordón umbilical
Objective

To evaluate calcium, phosphorus, parathormone (PTH),osteocalcin, and alkaline phosphatase concentrations in cord blood, pyridinoline concentrations in urine, and the pyridinoline/creatinine ratio in order to indirectly assess late bone remodeling in the newborn by comparing concentrations of these substances with those in the mother during the third trimester and delivery

Patients and methods

Calcium, phosphorus, PTH, osteocalcin, and alkaline phosphatase levels in cord blood, pyridinolines in urine and the pyridinoline/creatinine ratio were evaluated in 38 healthy pregnant women during the last two months of pregnancy and during delivery. To determine concentrations of these substances, samples from vein umbilical cord blood were obtained immediately after birth and urine samples were obtained from the neonates within 24 hours of delivery

Results

The mean calcium concentration in cord blood was higher than maternal values during delivery. Concentrations of PTH in cord blood were much lower than those in maternal blood during pregnancy, alkaline phosphatase levels were similar, and osteocalcin levels were higher. Mean urine pyridinoline concentrations in the neonates were much higher than those in the mother during the third trimester and delivery

Conclusion

During delivery newborn infants are hypercalcemic compared with their mothers, presenting a state of relative hypoparathyroidism. Concentrations of remodeling biomarkers are higher in the newborn than in the mother, revealing a higher rate of bone turnover in the fetus

Key words:
Osteocalcin
Pyridinolines
Pregnancy
Delivery
Umbilical cord
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