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Study of oxidative stress in common neonatal disorders and evaluation of antioxidant strategies

Objectives The aim of this work is to study oxidative stress and the profile of antioxidant mechanisms in common neonatal disorders. These disorders are prematurity, neonatal hyperbilirubinemia, and perinatal asphyxia. This study also aimed to evaluate the effect of treatment of these disorders on oxidative stress. Background In a broad sense, oxidative stress may be considered an imbalance between prooxidant and antioxidant forces or between the amount of reactive oxygen species and antioxidant defenses. The term oxygen radical disease of neonatology has been suggested to designate diseases whose pathogenesis includes tissue aggression from free radicals and reactive oxygen species. However, the mechanisms involved are more complex and involve more than oxidative stress; inflammation, infection, and other factors are important in preterm and neonatal diseases such as neonatal hyperbilirubinemia and exposure to perinatal asphyxia. Materials and methods Fifty neonates were studied. Clinical assessment, lab detection of antioxidant enzymes (catalase, glutathione perioxidase, and superoxide dismutase) in plasma, and oxidation reaction initiated by free radical products (F8-isoprostane and melanodialdehyde) in plasma at admission to NICU and before discharge were performed. After discharge, 15 neonates were studied as controls (healthy neonates being followed up at the outpatient clinic and matched for sex and postneonatal age). The remaining 35 neonates were divided into three groups: preterm group, hyperbilirubinemia group, and perinatal asphyxia group. Results At admission, the plasma level of antioxidant enzymes was insignificantly suppressed in the preterm group, except superoxide dismutase, which was significantly suppressed. The level of antioxidant enzymes was insignificantly higher in neonates with hyperbilirubinemia and significantly suppressed in neonates exposed to perinatal asphyxia; there was no significant difference in the level of oxidation reaction products in preterm and neonatal hyperbilirubinemia groups compared with the controls, but their level was significantly increased in neonates exposed to perinatal asphyxia. Before discharge, preterm patients received a higher concentration of oxygen (in the form of mechanical ventilation), and oxidation reaction products were significantly elevated as in neonates exposed to perinatal asphyxia. Conclusion Oxidative stress plays a definite role in the pathogenesis of complications caused by immaturity and neonatal exposure to oxidative stress favoring factors such as oxygen and many life-saving procedures used in the NICU.