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Intraerythrocyte nonprotein-bound iron and plasma malondialdehyde in the hypoxic newborn
G Buonocore1, S Zani, S Perrone
1Istituto di Pediatria Preventiva e Neonatologia, Università di Siena, Italia. buonocore@unisi.it
Insights
Newborns experiencing hypoxia show increased oxidative stress markers like malondialdehyde (MDA). Preterm infants and those requiring intubation had higher MDA levels, indicating red blood cells and lipoproteins are targets of this stress.
Area of Science:
- Neonatal Medicine
- Biochemistry
- Pediatric Research
Background:
- Oxidative stress is a significant concern in newborns, particularly those born preterm or experiencing hypoxic events.
- Malondialdehyde (MDA) is a key biomarker for lipid peroxidation and oxidative damage.
Purpose of the Study:
- To investigate the levels of intraerythrocyte nonprotein-bound iron (INPBI), malondialdehyde (MDA), and hypoxanthine plasma levels (HxPL) in newborns.
- To identify factors associated with elevated MDA levels in neonatal blood samples.
Main Methods:
- High-pressure liquid chromatography was used to quantify INPBI, MDA, and HxPL in 138 newborns.
- Blood samples were collected at birth (cord blood) and on the fourth day of life.
- Statistical analyses, including correlation and multiple regression, were performed.
Main Results:
- MDA plasma levels were significantly higher in preterm infants, those born via emergency Cesarean section, and intubated newborns.
- Significant correlations were found between MDA levels and gestational age, birth weight, Apgar scores, HxPL, pH, base deficit, and INPBI.
- Hypoxanthine plasma levels predicted MDA in cord blood, while INPBI predicted MDA in fourth-day blood.
Conclusions:
- Hypoxia-induced oxidative stress affects neonatal red blood cells and plasma lipoproteins.
- MDA levels serve as a sensitive indicator of oxidative stress in newborns, influenced by various clinical factors.
Abstract:
Intraerythrocyte nonprotein-bound iron (INPBI), malondialdehyde (MDA), and hypoxanthine plasma levels (HxPL), were determined by high-pressure liquid chromatography in 138 randomly selected newborn infants with gestational ages ranging from 23 to 42 weeks at birth and on fourth day of life. MDA plasma levels were significantly higher in cord and fourth-day blood samples of preterm babies than term infants as well as babies born by emergency Caesarean section than babies born by vaginal delivery and in intubated than in nonintubated newborns. Highly significant correlations both in cord blood and fourth-day blood samples were observed between MDA plasma levels and gestational age, birth weight, Apgar score at 1 min and 5 min, HxPL, pH, base deficit, and INPBI content. Multiple regression analysis identified HxPL as the best single predictor of MDA plasma levels in cord blood, and INPBI content in fourth-day blood as the best single predictor of MDA plasma levels in fourth-day blood. The results indicate that red cells and plasma lipoproteins are a common target of free radical-induced oxidative stress during hypoxia.