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Published on: November 20, 2015
Lipid peroxidation in cord blood and neonatal outcome
Barry Weinberger1, Salman Nisar, Mujahid Anwar
1Division of Neonatology, Department of Pediatrics, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA. barryw@pol.net
Insights
Fetal oxidant stress, measured by 8-isoprostane in umbilical venous cord blood, is linked to increased mortality and oxygen radical diseases (ORD) in preterm infants.
Area of Science:
- Neonatal Medicine
- Perinatal Biology
- Oxidative Stress Research
Background:
- Premature infants are susceptible to oxygen radical diseases (ORD) like intraventricular hemorrhage and necrotizing enterocolitis, linked to oxidant stress.
- 8-Isoprostane, a marker of lipid peroxidation, quantifies free radical damage.
- This study investigated the association between fetal oxidant stress and adverse outcomes in preterm neonates.
Purpose of the Study:
- To determine if fetal oxidant stress, indicated by 8-isoprostane levels, correlates with adverse outcomes in preterm infants.
- To assess the relationship between cord blood 8-isoprostane and neonatal mortality and ORD development.
Main Methods:
- Recruitment of mothers delivering preterm (<37 weeks gestation).
- Collection of umbilical arterial and venous cord blood samples.
- Measurement of 8-isoprostane levels and correlation with perinatal factors, mortality, and ORD.
Main Results:
- Elevated 8-isoprostane in umbilical venous blood, not arterial, correlated with mortality and ORD development.
- Increased log 8-isoprostane in venous cord blood significantly raised odds of mortality (12x) and ORD (2.7x), independent of gestational age.
- No association found between isoprostane levels and gender, delivery method, maternal treatments, or resuscitation.
Conclusions:
- In utero oxidant stress is a significant factor in preterm infant mortality and morbidity.
- High umbilical venous isoprostane levels suggest maternal/placental oxidative injury contributes to adverse neonatal outcomes.
Background:
Periventricular-intraventricular hemorrhage, necrotizing enterocolitis, chronic lung disease and retinopathy of prematurity have been referred to as oxygen radical diseases (ORD) because they are thought to be related to excess oxidant stress relative to anti-oxidant defenses in premature infants. 8-Isoprostane is a product of lipid peroxidation that can be used as a measure of free radical exposure or injury. The aim of the present study was to determine whether fetal oxidant stress is associated with adverse effects in preterm infants.
Methods:
Mothers delivering at gestational age <37 weeks were recruited. Umbilical arterial and venous cord blood samples were collected and 8-isoprostane levels measured. Levels of 8-isoprostane in cord blood were correlated with maternal and perinatal variables, neonatal mortality, and the development of one or more ORD.
Results:
Umbilical cord venous, but not arterial, 8-isoprostane levels were associated with mortality and the development of one or more of the ORD. After controlling for gestational age, for each unit change in the log value of 8-isoprostane in venous cord blood the odds of mortality were 12 (95% confidence interval [CI]: 1-223) and oxygen radical disease were 2.7 (95%CI: 1-7.2). Isoprostane levels were not related to gender, method of delivery, use of maternal magnesium or steroids, pregnancy-induced hypertension, or delivery room resuscitation.
Conclusion:
Oxidant stress in utero may be an important determinant of mortality and morbidity in preterm infants. Elevated umbilical venous isoprostane levels suggest that oxidative injury to maternal and placental tissues predispose to adverse neonatal outcomes.
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