Correlation between Severity of Fetal Growth Restriction and Oxidative Stress in Severe Small-for-Gestational-Age Infants.

Mariko Ashina,Takumi Kido,Asumi Yoshida,Kazumichi Fujioka,Kenji Tanimura,Ruka Nakasone,Kandai Nozu,Shinya Abe,Yuki Kyono,Shutaro Suga

doi:10.3390/ijerph182010726

Abstract

Severe small-for-gestational-age (sSGA) infants exhibit increased mortality and morbidity. Oxidative stress is suggested to be involved in intrauterine growth restriction. This retrospective study aimed to evaluate the oxidative stress level at birth in an sSGA population. Sera of 28 sSGA (sSGA group) and 31 non-sSGA (control group) infants, born at our hospital between March 2017 and March 2020, were evaluated. Oxidative stress (derivative of reactive oxidative metabolites: d-ROM level), biological antioxidant potential (BAP) level, and the ratio of d-ROM/BAP level (oxidative stress index: OSI) were measured. The sSGA group had a significantly lower birth weight (BW), BW z-score, head circumference, and height than the control group (all p < 0.05). No significant difference was noted in the BAP level; sSGA infants exhibited a significantly higher d-ROM level than control infants. sSGA infants showed a significantly increased OSI compared with control infants, and the BW z-score was inversely correlated with d-ROM levels and OSI in sSGA infants (R2 = 0.300; p < 0.01 and R2 = 0.319; p = 0.02, respectively) but not in controls. In conclusion, sSGA infants, including preterm infants, exhibited higher oxidative stress at birth. The severity of fetal growth restriction was significantly correlated with oxidative stress levels at birth in sSGA infants.

Highlights

Small-for-gestational-age (SGA) infants are smaller in size than normal for their gestational age infants; these infants usually experience intrauterine growth restriction as fetuses [1]
In recent years, it has been revealed that infants born with severe SGA and birth weight (BW) > two standard deviations (SDs) below the mean BW of newborns [4,5] are associated with more serious complications [1,6,7]
Several reports have suggested that SGA infants are exposed to prolonged excessive oxidative stress caused by intrauterine malnutrition and hypoxia, no studies have examined oxidative status in an severe SGA (sSGA) population [8,9]

Summary

Introduction

Small-for-gestational-age (SGA) infants are smaller in size than normal for their gestational age infants; these infants usually experience intrauterine growth restriction as fetuses [1]. In recent years, it has been revealed that infants born with severe SGA (sSGA) and birth weight (BW) > two standard deviations (SDs) below the mean BW of newborns [4,5] are associated with more serious complications [1,6,7]. Several reports have suggested that SGA infants are exposed to prolonged excessive oxidative stress caused by intrauterine malnutrition and hypoxia, no studies have examined oxidative status in an sSGA population [8,9]. Excessive oxidative stress has been implicated in the pathophysiology of various complications, including bronchopulmonary dysplasia, hypoxic-ischemic encephalopathy, retinopathy of prematurity, periventricular leukomalacia, intraventricular hemorrhage, and necrotizing

Methods

Discussion

Conclusion