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Source and Quality of Enteral Nutrition Influences Oxidative Stress in Preterm Infants: A Prospective Cohort Study

Gerhard Fusch1,2, Souvik Mitra2, Heinrich Topp1

  • 1Division of Neonatology and Pediatric Intensive Care, Department of Pediatrics, University of Greifswald, Greifswald, Germany.

JPEN. Journal of Parenteral and Enteral Nutrition
|April 1, 2018
PubMed

Insights

Enteral nutrition source impacts oxidative stress in preterm infants. Formula feeding showed higher 8-oxodG levels, a marker of DNA damage, compared to breast milk or mixed feeding.

Area of Science:

  • Neonatal Medicine
  • Biochemistry
  • Pediatric Nutrition

Background:

  • Preterm infants face oxidative stress from neonatal intensive care.
  • 8-Oxo-2'-deoxyguanosine (8-oxodG) is a marker for DNA damage due to oxidative stress.
  • Investigating nutritional impacts on oxidative stress is crucial for preterm infant health.

Purpose of the Study:

  • To assess how enteral nutrition (EN) quality and source affect renal 8-oxodG excretion in preterm infants.
  • To determine if iron supplementation influences oxidative stress markers.
  • To explore potential mechanisms behind observed nutritional effects.

Main Methods:

  • Collected spontaneous urine samples from 33 preterm infants (postnatal days 26-31).
  • Infants received either breast milk (BM), formula (FM), or a BM/FM mix.
  • Measured 8-oxodG levels using high-performance liquid chromatography-electrochemical detection (HPLC-EC); iron supplementation was initiated on day 28.

Main Results:

  • The 8-oxodG/creatinine ratio was significantly higher in infants fed FM compared to BM/FM mix or BM alone (P < 0.0001).
  • Iron supplementation showed no significant effect on 8-oxodG excretion (P = 0.547).
  • Significant interindividual variation in 8-oxodG excretion was observed, but levels were similar within twin pairs.

Conclusions:

  • The quality and source of enteral nutrition appear to influence oxidative stress in preterm infants.
  • The exact pathophysiological mechanisms require further investigation.
  • Factors beyond iron supplementation, potentially cow's milk protein-induced inflammation, may contribute to oxidative stress.
Abstract

Keywords:
8-oxo-2′-deoxyguanosinebiomarkerbreast milkhigh-performance liquid chromatographyhuman milk fortificationpreterm formula

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