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Updated: Jun 13, 2026
Free Radicals in Chemical Biology: from Chemical Behavior to Biomarker Development
Published on: April 15, 2013
Early identification of the risk for free radical-related diseases in preterm newborns
Serafina Perrone1, Maria Luisa Tataranno, Simona Negro
1Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Italy.
Insights
Elevated oxidative stress markers in cord blood, including total hydroperoxides (TH), advanced oxidation protein products (AOPP), and non-protein bound iron (NPBI), predict the risk of free radical-related diseases in preterm newborns.
Area of Science:
- Neonatal Medicine
- Biochemistry
- Perinatal Health
Background:
- Perinatal pathologies and disabilities are increasing in preterm newborns despite healthcare advances.
- Oxidative stress (OS) plays a key role in the pathogenesis of 'free radical-related diseases' (FRD) like ROP, BPD, NEC, and IVH.
- OS results from an imbalance between free radical production and antioxidant systems.
Purpose of the Study:
- To test the hypothesis that cord blood OS marker levels can predict the onset of FRD in preterm infants.
- To identify early indicators of oxidative stress-related risks in neonates.
Main Methods:
- 168 preterm newborns (GA: 24-32 weeks) were recruited.
- Cord blood levels of OS risk markers (non-protein bound iron - NPBI; basal superoxide anion - BSA; under stimulation superoxide anion - USSA) and OS damage markers (total hydroperoxides - TH; advanced oxidation protein products - AOPP) were assessed.
- Univariate logistic regression was used to analyze associations between FRD onset and OS markers.
Main Results:
- High cord blood levels of TH, AOPP, and NPBI were significantly associated with the development of FRD.
- Specifically, elevated TH (p=0.000), AOPP (p=0.014), and NPBI (p=0.007) showed significant predictive value for FRD onset.
- Odds ratios indicated increased risk with higher levels of these markers.
Conclusions:
- Elevated cord blood levels of TH, AOPP, and particularly NPBI, are linked to an increased risk of FRD.
- OS markers in cord blood enable early identification of preterm infants at risk for FRD due to perinatal oxidant exposure.
- This early identification can inform strategies for preventing or mitigating adverse perinatal outcomes.
Background:
Despite recent advances in preterm newborns healthcare, perinatal pathologies and disabilities are increasing. Oxidative stress (OS) is determinant for the onset of an unbalance between free radicals (FRs) production and antioxidant systems which plays a key role in pathogenesis of pathologies such as retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), grouped as 'free radical-related diseases' (FRD).
Aim:
This study tests the hypothesis that OS markers levels in cord blood may predict the onset of FRD pathologies.
Patients And Methods:
168 preterm newborns of GA: 24-32weeks (28.09+/-1.99); and BW: 470-2480 gr (1358.11+/-454.09) were consecutively recruited. Markers of potential OS risk (non-protein bound iron, NPBI; basal superoxide anion, BSA; under stimulation superoxide anion, USSA) and markers of OS-related damage (total hydroperoxides, TH; advanced oxidation protein products, AOPP) were assessed in cord blood. Associations between FRD onset and OS markers were checked through inferential analysis (univariate logistic regression).
Results:
The development of FRD was significantly associated to high cord blood levels of TH, AOPP and NPBI (respectively p=0.000, OR=1.025, 95%CI=1.013-1.038; p=0.014, OR=1.092, 95%CI=1.018-1.172; p=0.007, OR=1.26995%CI=1.066-1.511).
Conclusions:
Elevated levels of TH, AOPP and, above all, NPBI, in cord blood are associated with increased risk for FRD. OS markers allow the early identification of infants at risk for FRD because of perinatal oxidant exposure. This can be useful in devising strategies to prevent or ameliorate perinatal outcome.
