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THE PERSISTENCE OF NON-PROTEIN-BOUND PLASMA IRON IN PRETERM INFANTS

Non-protein-bound iron (npb-iron), a potent prooxidant, is present in newborn plasma, and can induce peroxidation of surfactant (Moison et al, Lancet 1993;341:79). This study assessed the persistence of npb-iron (bleomycine assay) in 26 infants (GA; 26-34 wks) for the first 10 days of life. Npb-iron was present in 10 (38%), 7 (27%) and 2 (8%) infants at day 1, 4 and 10 respectively. In 5 babies npb-iron was not present at day 1 but developed at day 4, and in 2 of them it persisted until day 10. Npb-iron was more frequently present in the more immature babies (p<0.01) and in babies with a longer duration of O2 therapy (mean(SD): npb-iron pos 121.4 (174.8), npb-iron neg: 22.3 (40.0) hrs, p<0.01), whereas the level of the peroxidation product TBARS did not differ in infants with or without npb-iron. The babies who developed npb-iron at day 4 had a longer duration of O2 therapy than babies with npb-iron already present at day 1 (p<0.01). Npb-iron induced oxidative damage could play a role in the pathogenesis of acute and chronic lung disease in the newborn.