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Updated: Jul 30, 2025
Biochemical Measurement of Neonatal Hypoxia
Published on: August 24, 2011
Hypoxemia events in preterm neonates are associated with urine oxidative biomarkers
Thomas M Raffay1, Juliann M Di Fiore2, Zhengyi Chen3
1Department of Pediatrics, Division of Neonatology, University Hospitals Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OH, USA. Thomas.Raffay@UHhospitals.org.
Insights
Intermittent hypoxemia (IH) in preterm infants is linked to oxidative stress. Urine biomarkers indicate lipid, protein, and DNA damage, suggesting IH may contribute to adverse outcomes in neonates.
Area of Science:
- Neonatal Medicine
- Biochemistry
- Oxidative Stress Research
Background:
- Intermittent hypoxemia (IH) is common in preterm neonates and linked to poor outcomes.
- Animal models show IH induces oxidative stress.
- This study investigates IH and peroxidation products in preterm infants.
Purpose of the Study:
- To explore the association between IH parameters and oxidative stress biomarkers in preterm neonates.
- To determine if urine analysis can detect oxidative damage related to IH.
- To identify potential biomarkers for high-risk neonates.
Main Methods:
- Prospective cohort study of 170 preterm neonates (<31 weeks gestation).
- IH parameters (time, frequency, duration) were assessed.
- Urine samples analyzed for lipid, protein, and DNA oxidation biomarkers at 1 week and 1 month.
Main Results:
- At 1 week, IH parameters correlated with various oxidation biomarkers (isofurans, neurofurans, tyrosine).
- At 1 month, IH parameters showed associations with isoprostanes, dihomo-isoprostanes, and dihomo-isofurans.
- Some negative correlations were observed between IH parameters and specific biomarkers at both time points.
Conclusions:
- Preterm neonates exhibit oxidative damage to lipids, proteins, and DNA, detectable in urine.
- IH exposure in preterm infants is associated with specific oxidative stress markers.
- Further research is needed to clarify mechanisms and links to prematurity morbidities.
Background:
Intermittent hypoxemia (IH) events are common in preterm neonates and are associated with adverse outcomes. Animal IH models can induce oxidative stress. We hypothesized that an association exists between IH and elevated peroxidation products in preterm neonates.
Methods:
Time in hypoxemia, frequency of IH, and duration of IH events were assessed from a prospective cohort of 170 neonates (<31 weeks gestation). Urine was collected at 1 week and 1 month. Samples were analyzed for lipid, protein, and DNA oxidation biomarkers.
Results:
At 1 week, adjusted multiple quantile regression showed positive associations between several hypoxemia parameters with various individual quantiles of isofurans, neurofurans, dihomo-isoprostanes, dihomo-isofurans, and ortho-tyrosine and a negative correlation with dihomo-isoprostanes and meta-tyrosine. At 1 month, positive associations were found between several hypoxemia parameters with quantiles of isoprostanes, dihomo-isoprostanes and dihomo-isofurans and a negative correlation with isoprostanes, isofurans, neuroprostanes, and meta-tyrosine.
Conclusions:
Preterm neonates experience oxidative damage to lipids, proteins, and DNA that can be analyzed from urine samples. Our single-center data suggest that specific markers of oxidative stress may be related to IH exposure. Future studies are needed to better understand mechanisms and relationships to morbidities of prematurity.
Impact:
Hypoxemia events are frequent in preterm infants and are associated with poor outcomes. The mechanisms by which hypoxemia events result in adverse neural and respiratory outcomes may include oxidative stress to lipids, proteins, and DNA. This study begins to explore associations between hypoxemia parameters and products of oxidative stress in preterm infants. Oxidative stress biomarkers may assist in identifying high-risk neonates.
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