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Published on: October 11, 2011
The Relationship between Oxidative Stress, Intermittent Hypoxemia, and Hospital Duration in Moderate Preterm Infants
Vidhi P Shah1,2, Thomas M Raffay1,2, Richard J Martin1,2
1Division of Neonatology, Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA.
Insights
Lipid peroxidation products and intermittent hypoxemia (IH) are linked in moderate preterm infants. Higher levels of these oxidative stress markers in the first weeks of life correlate with longer hospital stays.
Area of Science:
- Neonatal physiology
- Oxidative stress biomarkers
- Preterm infant health
Background:
- Lipid peroxidation products are elevated in preterm infants, particularly those with intermittent hypoxemia (IH).
- The oxidant defense system and respiratory control are immature in moderate preterm newborns.
- Little is known about the relationship between lipid peroxidation and IH in this population.
Purpose of the Study:
- To investigate the association between oxidative stress and IH in moderate preterm infants.
- To explore the clinical significance of lipid peroxidation products in this vulnerable group.
Main Methods:
- Continuous oxygen saturation monitoring in 51 moderate preterm infants (31-33 weeks gestation).
- Urine sample collection at weeks 1 and 2 of life.
- Analysis of urine for total lipid peroxidation products, including neurofurans and isoprostanes.
Main Results:
- A correlation was found between increased IH frequency and elevated neurofurans and di-homo-isofurans at week 1 (p < 0.04 and p < 0.003, respectively).
- No significant correlation between IH and lipid peroxidation markers was observed at week 2.
- Elevated lipid peroxidation markers in the first weeks were associated with longer hospitalization.
Conclusions:
- Increased lipid peroxidation biomarkers in moderate preterm infants are associated with higher IH frequency during the first weeks of life.
- These oxidative stress markers are linked to prolonged hospitalization in this population.
Introduction:
Lipid peroxidation products are present following oxidation of polyunsaturated fatty acids in the eye, brain, and various cell membranes. Elevated levels of lipid peroxidation products and increased intermittent hypoxemia (IH) events have been associated with adverse outcomes in extremely preterm infants. The moderate preterm newborn has a still-developing oxidant defense system and immature respiratory control, but little is known about lipid peroxidation levels and IH in this larger and more common preterm population.
Objective:
To determine the association between oxidative stress and IH in moderate preterm infants.
Method:
Oxygen saturation was continuously monitored in 51 moderate preterm infants (i.e., 31 + 0/7 to 33 + 6/7 weeks' gestation). Urine samples were collected at the end of the first and second weeks of life. Samples were analyzed for total lipid peroxidation products (neurofurans, isofurans, neuroprostanes, isoprostanes, and di-homo-isofurans).
Result:
At week 1, there was a correlation between increased IH frequency and neurofurans (p < 0.04) and di-homo-isofurans (p < 0.003). At week 2, there was no correlation between IH and lipid peroxidation markers. Ele-vations in neurofurans, isofurans, neuroprostanes, and di-homo-isofurans in the first and/or second week of life were associated with a longer stay in hospital.
Conclusion:
Elevations in lipid peroxidation biomarkers in moderate preterm infants during their first weeks of life are associated with a higher frequency of IH and prolonged hospitalization.
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