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Antioxidant capacity and oxygen radical diseases in the preterm newborn
1Department of Pediatrics, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School and St Peter's University Hospital, New Brunswick 08903, USA.
Insights
Antioxidant capacity in cord blood serum correlates with gestational age in premature infants. However, it does not predict the risk of oxygen radical diseases of prematurity (ORDP).
Area of Science:
- Neonatal Medicine
- Biochemistry
- Pediatric Critical Care
Background:
- Bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, and retinopathy of prematurity are potential manifestations of oxygen radical diseases of prematurity (ORDP).
- Assessing antioxidant capacity in cord blood serum may offer insights into predicting these conditions.
Purpose of the Study:
- To investigate the hypothesis that cord blood serum antioxidant capacity can predict the risk of developing ORDP in premature neonates.
- To explore correlations between antioxidant capacity and various perinatal factors.
Main Methods:
- An inception cohort of premature neonates was studied from birth to discharge.
- Cord blood serum antioxidant capacity was measured using a manual assay for the relative inhibition of oxidation of 2,2'-azino-di-(3-ethylbenzthiazoline)-6 sulfonic acid (ABTS).
- Neonates were monitored for significant ORDP, defined by specific criteria for intraventricular hemorrhage, retinopathy of prematurity, bronchopulmonary dysplasia, and necrotizing enterocolitis.
Main Results:
- Serum antioxidant capacity at birth showed a correlation with gestational age in the overall sample and in neonates born before 32 weeks' gestation.
- After adjusting for gestational age, cord serum antioxidant capacity did not correlate with maternal smoking, preeclampsia, chorioamnionitis, cord pH, Apgar scores, or any of the studied ORDP.
- No significant association was found between cord blood antioxidant capacity and the development of ORDP.
Conclusions:
- Cord blood serum antioxidant capacity is associated with gestational age in premature neonates.
- Cord blood serum antioxidant capacity does not serve as a predictor for the risk of oxygen radical diseases of prematurity (ORDP).
Background:
Bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, and retinopathy of prematurity may be different manifestations of oxygen radical diseases of prematurity (ORDP).
Objective:
To test the hypothesis that the antioxidant capacity of cord blood serum will predict risk of ORDP.
Design:
An inception cohort of premature neonates was followed up from birth until discharge or death to determine if outcome was related to cord blood serum antioxidant capacity, as determined by a manual assay measuring the relative inhibition of oxidation of 2,2'-azino-di-(3-ethylbenzthiazoline)-6 sulfonic acid (ABTS). Possible correlations between antioxidant capacity and various perinatal factors were also tested.
Setting:
Level 3 newborn intensive care unit.
Patients:
All inborn very low-birth-weight neonates from whom cord blood was available and for whom maternal consent was obtained were included. Newborns who died in the first week of life or who had major congenital malformations were excluded. A convenience sample of newborns weighing more than 1500 g was used to perfect assay and explore confounders.
Main Outcome Measures:
Significant ORDP was defined as the presence of intraventricular hemorrhage greater than grade 2, retinopathy of prematurity greater than stage 1, bronchopulmonary dysplasia at the postconceptional age of 36 weeks, or necrotizing enterocolitis with the hypothesis that neonates with ORDP will have lower antioxidant capacity in cord blood serum.
Results:
Serum antioxidant capacity at birth correlated with gestational age for the entire sample of 41 neonates and for the 26 neonates born before 32 weeks' gestation. After correction for gestational age, cord serum antioxidant capacity did not correlate with maternal smoking, preeclampsia, chorioamnionitis, cord pH Apgar scores, or any of the ORDP studied.
Conclusion:
Cord serum antioxidant capacity correlates with gestational age but does not predict ORDP risk.