Urinary Malondialdehyde Levels in Newborns following Delivery Room Resuscitation

Abstract

Background: Delivery room resuscitation (DRR) is a common emergency in newborns, particularly in resource-poor settings where intrapartum monitoring is not readily available. It may give rise to oxidative stress in neonates due to reoxygenation and reperfusion of previously hypoxic and ischemic tissues. Urinary malondialdehyde (MDA), being non-invasive, may serve as a marker of oxidative stress in these infants. Objective: We assessed oxidative stress in term newborns requiring DRR by measuring MDA levels in urine and serum samples collected at 12–24 h of age. Methods: The study population consisted of 41 cases and 63 healthy age-matched control infants. The inclusion criterion was a need for positive pressure ventilation at birth for >1 min. MDA levels were measured colorimetrically by thiobarbituric acid reaction. Results: Urinary and serum MDA levels were found to be significantly higher in cases than in controls. Of the neonates given DRR, urinary and serum MDA values were elevated in those infants who passed meconium in utero, developed hypoxic ischemic encephalopathy or expired than in those who did not have these complications, but the difference was not significant. We found a significant correlation between urinary and serum MDA levels in infants given DRR. Conclusion: Newborns requiring DRR are subjected to significant oxidative stress which can be easily assessed by measuring urinary MDA levels.