Predictors of adverse outcomes in preterm infants in the early neonatal period
DOI:
https://doi.org/10.12775/JEHS.2020.10.10.035Keywords
preterm infant, oxidative stress, early neonatal period, adverse outcomes, favorable outcomesAbstract
Introduction. Extremely and very preterm infants are a special cohort of newborns with inherent functional immaturity and specific pathological conditions which are accompanied by hypoxia, reoxygenation, tissue hypoperfusion, increased risk of oxidative stress. Premature infants are prone to oxidative deterioration which plays a key role in the pathogenesis of severe diseases such as respiratory distress syndrome, necrotizing enterocolitis, periventricular leukomalacia, patent ductus arteriosus, bronchopulmonary dysplasia, and retinopathy of prematurity.
Objective. The aim of the research was to estimate the predictors of adverse outcomes in preterm infants with gestational age less than 32 weeks in the early neonatal period by assessment of oxidative stress markers.
Material and methods. A total amount of 46 preterm infants with gestational age less than 32 weeks in the early neonatal period were included in the research. According to the results of early outcomes newborns were divided into two groups: I group – 12 infants with adverse outcomes and II group - 34 preterm infants with favorable outcomes. Twenty healthy newborns were included in the control group (III group). Clinical examination of infants and laboratory determination of oxidative stress markers were done for all participants.
Results. Asphyxia, early onset sepsis, intraventricular hemorrhage in preterm infants less than 32 weeks of gestation had increased the risk of mortality in the early neonatal period. The level of 8-isoprostane, ROS, TBP, LHP was significantly higher in neonates with adverse outcomes (group I). It was found that the level of 8-isoprostane more than 595.4 mg/ml, ROS level above 0.483 IU, TBP higher than 5.14 μmol/l and LHP levels above 5.91 U/m were associated with unfavorable outcomes in the early neonatal period. Decreased activity of the antioxidant system (catalase, SOD) increases the risk of early neonatal mortality.
Conclusions. The activation of oxidative stress in preterm infants may be a predictor of adverse outcomes in the early neonatal period.
References
WHO; Howson C, Kinney M, Lawn J (Eds.). Born Too Soon: The Global Action Report on Preterm Birth. Geneva, Switzerland: World Health Organization, 2012.
Guillen U, Weiss EM, Munson D, Maton P, Jefferies A, Norman M, Naulaers G, Mendes J, Justo da Silva L, Zoban P, Hansen TW, Hallman M, Delivoria-Papadopoulos M, Hosono S, Albersheim SG, Williams C, Boyle E, Lui K, Darlow B, Kirpalani H. Guidelines for the Management of Extremely Premature Deliveries: A Systematic Review. Pediatrics. 2015;136(2):343-50.
Liu L, Oza S, Hogan D, et al. Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet. 2016;388(10063):3027-35. doi: 10.1016/S0140-6736(16)31593-8.
Peña-Bautista C, Durand T, Vigor C, Oger C, Galano JM, Cháfer-Pericás C. Non-invasive assessment of oxidative stress in preterm infants. Free Radic Biol Med. 2019;142:73-81. doi: 10.1016/j.freeradbiomed.2019.02.019
Ozsurekci Y, Aykac K. Oxidative Stress Related Diseases in Newborns. Oxid Med Cell Longev. 2016;2016:2768365. https://doi.org/10.1155/2016/2768365 PMid:27403229 PMCid:PMC4926016.
Marseglia L, D'Angelo G, Manti S, et al. Oxidative stress-mediated gained during the fetal and perinatal periods. Oxid Med Cell Longev. 2014;2014:358–375. https://doi.org/10.1155/2014/358375 PMid:25202436 PMCid:PMC4151547.
Chessex P, Watson C, Kaczala GW, et al. Determinants of oxidant stress in extremely low birth weight premature infants. Free Radic Biol Med. 2010;49:1380–6. doi: 10.1016/j.freeradbiomed.2010.07.018.
Platt MJ. Outcomes in preterm infants. Public Health. 2014;128(5):399-403. doi: 10.1016/j.puhe.2014.03.010.
Mutinati M, Pantaleo M, Roncetti M, Piccinno M, Rizzo A, Sciorsci RL. Oxidative stress in neonatology: a review, Reprod Domest Anim. 2014;49(1):7–16. https://doi.org/10.1111/rda.12230 PMid:24112309.
Perron S, Tataranno ML, Negro S, et al. Early identification of the risk for free radical-related diseases in preterm newborns. Early Human Development.2010;86(4):241-244. https://doi.org/10.1016/j.earlhumdev.2010.03.008 PMid:20466493.
Bahbah M, Deeb M, Ragab S, El-Shafie M. Study of oxidative stress in common neonatal disorders and evaluation of antioxidant strategies. Menoufia Medical Journal. 2015;28:348–354. https://doi.org/10.4103/1110-2098.163883.
Vento M, Aguar M, Escobar J, Arduini A, Escrig R, Brugada M, et al. Antenatal steroids and antioxidant enzyme activity in preterm infants: influence of gender and timing. Antioxid Redox Signal. 2009;11:2945-2955. https://doi.org/10.1089/ars.2009.2671 PMid:19645572.
Downloads
Published
How to Cite
Issue
Section
License
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 214
Number of citations: 0
