Plasma ascorbate and ceruloplasmin levels in Thai premature infants
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Updated: Aug 12, 2026
Biochemical Measurement of Neonatal Hypoxia
Published on: August 24, 2011
Patcharee Boonsiri1, Charnchai Panthongviriyakul, Pakaphan Kiatchoosakun
1Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand. patcha_b@kku.ac.th
Insights
High plasma ascorbate levels in premature infants correlate with poor outcomes, suggesting ascorbate can act as a pro-oxidant. This highlights the complex role of antioxidants in neonatal health.
Area of Science:
- Neonatal Medicine
- Biochemistry
- Oxidative Stress Research
Background:
- Free radicals contribute to neonatal complications.
- Ascorbate (vitamin C) is a key plasma antioxidant but can become pro-oxidant at high concentrations with metal ions, potentially causing oxidative damage in premature infants.
Purpose of the Study:
- To measure plasma ascorbate and ceruloplasmin levels in premature infants, their mothers, and full-term infants.
- To compare these levels across different infant groups and clinical conditions.
Main Methods:
- Study included 27 premature infants, 24 full-term infants, and 13 mothers of premature infants at Srinagarind Hospital, Thailand.
- Plasma ascorbate and ceruloplasmin levels were quantified.
- Levels were analyzed in relation to clinical presentations and outcomes.
Main Results:
- Plasma ascorbate levels showed a negative correlation with gestational age.
- Premature infants had higher initial plasma ascorbate than full-term infants, which decreased post-birth.
- Lower plasma ascorbate was observed in premature infants on oxygen therapy (p=0.017).
- Higher plasma ascorbate levels were found in premature infants who died compared to survivors (p=0.029).
- A higher ascorbate-to-ceruloplasmin ratio was linked to poor outcomes in premature infants (p < 0.05).
Conclusions:
- Elevated plasma ascorbate and diminished ceruloplasmin levels are associated with adverse outcomes in premature infants.
- This indicates that ascorbate's role can shift between antioxidant and pro-oxidant depending on the physiological context.
Background:
Free radicals have been implicated in the pathogenesis of some complications among premature infants. Even though ascorbate is an important anti-oxidant in human plasma, it can also act as a pro-oxidant at high concentrations in the presence of metal ions, which causes oxidative damage in premature infants.
Objective:
To determine plasma ascorbate and ceruloplasmin levels in premature infants (and their mothers) and full-term infants and to compare between groups.
Material And Method:
Premature (n = 27) and full-term infants (n = 24) and the mothers of the premature infants (n = 13) admitted to Srinagarind Hospital, Khon Kaen University, Thailand, were enrolled in the study. Plasma ascorbate and ceruloplasmin levels were determined and compared among various clinical presentations.
Results:
Plasma ascorbate has negative correlation with gestational age of infants. Its level on day 1 of the premature infants was significantly higher than full-term group (52.62 vs 39.00 micromol/L) and then decline after birth. Premature infants receiving oxygen therapy had lower plasma ascorbate than premature infants without oxygen therapy (p = 0.017). Plasma ascorbate in premature infants who died was higher than in those that survived (p = 0.029). Premature infants with poor outcomes had a higher ratio of plasma ascorbate to ceruloplasmin than those with good outcomes (p < 0.05).
Conclusion:
This study shows that high plasma ascorbate and low ceruloplasmin levels are associated with poor outcomes of premature infants; that is, ascorbate can act as either an anti-oxidant or a pro-oxidant.
