Abstract
Preterm infants (PT) are particularly exposed to oxidative stress (OS), and a blood-sparing marker, the malondialdehyde adduct to hemoglobin (MDA-Hb), may be useful to accurately assess OS-related neonatal morbidity. In a prospective study, MDA-Hb concentrations were assessed in two groups of PT, one with and one without severe neonatal morbidity as estimated by a composite index of severe morbidity (ISM). All PT born in a single tertiary care NICU (<32 weeks and birth weight <1500 g) were consecutively included. MDA-Hb and blood glutathione (GSH) concentrations were measured by liquid chromatography-mass spectrometry during the first 6 weeks of life. Linear regressions and a multilevel model were fitted to study the relationship between MDA-Hb or GSH and ISM. Of the 83 PT (mean ± SD: 28.3 ± 2 weeks, 1089 ± 288 g), 21% presented severe neonatal morbidity. In the multivariate model, MDA-Hb concentrations were significantly higher in the ISM+ group than in the ISM– group during the first 6 weeks of life (P = 0.009). No significant difference in GSH concentrations was observed between groups (P = 0.180). MDA-Hb is a marker of interest for estimating oxidative stress in PT and could be useful to evaluate the impact of strategies to improve perinatal outcomes.
Highlights
As very low birth weight (VLBW) infants present an imbalance between the prooxidant and antioxidant systems [1,2,3], they are at high risk for oxidative-stress- (OS-) related damage
A relationship has been suggested between lipid peroxidation and several common morbidities of prematurity, including bronchopulmonary dysplasia (BPD), retinopathy of prematurity, periventricular leukomalacia, and necrotizing enterocolitis (NEC) [10,11,12,13]
Between February and July, 2009, 83 VLBW infants were consecutively enrolled in this study, 40% of whom were very immature (GA ≤ 28 wks)
Summary
As very low birth weight (VLBW) infants present an imbalance between the prooxidant and antioxidant systems [1,2,3], they are at high risk for oxidative-stress- (OS-) related damage. Antioxidant enzymes mature in late gestation, and the maternal-fetal transfer of antioxidant molecules like alpha-tocopherol and ascorbic acid is not complete in premature neonates [4]. These infants often require oxygen therapy and a parenteral nutrition. Parenteral nutrition solutions contain antioxidant molecules like vitamins A, C, and E, they contain polyunsaturated fatty acids that are sensitive to peroxidation, which generates toxic byproducts of the reactive oxygen species [5, 6]. The lipid peroxidation in these solutions depends on their composition and is increased by light exposure [7,8,9]. The studies show discrepancies because of differences in peroxidation assessment
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