Oxidative Stress and Preterm Birth: An Integrative Review

Moore, Tiffany A.; Ahmad, Iman M.; Zimmerman, Matthew C.

doi:10.1177/1099800418791028

Cited by 117 publications

(106 citation statements)

References 71 publications

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“…The results of these determinations are expressed as ratios, such as the o-Tyr/Phe, m-Tyr/Phe, 3NO2-Tyr/p-Tyr, and 3Cl-Tyr/p-Tyr ratios. These markers have been validated and extensively applied in the clinical setting in various human biofluid matrices, such as amniotic fluid, urine, plasma, cerebrospinal fluid, or human milk in the newborn period [16,24,29,31,36,[61][62][63][64]. In urine, in a pre-clinical study conducted on pig pups, we found a significant increase in both urinary o-tyrosine and 8-oxodG levels after 15 min of hyperoxia by resuscitation [62].…”

Section: Proteinsmentioning

confidence: 74%

“…These are non-enzymatic products from the oxidation of amino acid-free radicals and other PUFAs, and are chemically stable. These compounds have been detected electively in lipid-rich tissues, such as brain tissue, which, being rich in polyunsaturated lipids, is highly sensitive to oxidative stress [ 16 , 17 , 18 , 19 , 20 , 21 , 25 , 29 , 30 , 33 , 34 , 35 , 40 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 61 , 65 , 66 , 67 ].…”

Section: Discussionmentioning

confidence: 99%

“…In chemistry, "anti-oxidant" is simply conceived as "a compound that removes reactive species, mainly those oxygen-derived" [15]. Their functions can be classified into distinct defense lines, according to their mechanisms of action: (a) preventative agents that suppress new radicals formation (which includes enzymes, such as superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX), proteins that bind metals, like ferritin and ceruloplasmin, and minerals such as selenium (Se), copper (Cu), and zinc (Zn) [16,17]); (b) radical scavenging agents that inhibit chain initiation and/or propagation, which includes glutathione, albumin, vitamins C and E, carotenoids, and flavonoids; (c) repair and de novo enzymes that repair and reconstitute cell membranes, which include lipases, proteases, DNA repair enzymes, transferases, and methionine-sulfoxide reductases; and (d) adaptation agents that generate appropriate antioxidant enzymes and transfer them to the essential site of action [14,18]. Another category of antioxidants is peroxiredoxins (Prxs), a ubiquitous family of cysteine-dependent peroxidase enzymes that play dominant roles in regulating peroxide levels within cells.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, Prxs might act as modulators of inflammation, protecting against cell death and facilitating tissue repair after damage [19,20]. In addition, the potential for intracellular free radical production is greatly reduced by the ability of mitochondrial cytochrome oxidase to function catalytically in the electron transport chain without releasing ROS [8][9][10][11][12][13][14][15][16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

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Oxidative Stress in Preterm Infants: Overview of Current Evidence and Future Prospects

et al. 2020

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Preterm birth (PTB), defined as parturition prior to 37 weeks of gestation, is the leading cause of morbidity and mortality in the neonatal population. The incidence and severity of complications of prematurity increase with decreasing gestational age and birthweight. The aim of this review study is to select the most current evidence on the role of oxidative stress in the onset of preterm complication prevention strategies and treatment options with pre-clinical and clinical trials. We also provide a literature review of primary and secondary studies on the role of oxidative stress in preterm infants and its eventual treatment in prematurity diseases. We conducted a systematic literature search of the Medline (Pubmed), Scholar, and ClinicalTrials.gov databases, retroactively, over a 7-year period. From an initial 777 articles identified, 25 articles were identified that met the inclusion and exclusion criteria. Of these, there were 11 literature reviews: one prospective cohort study, one experimental study, three case-control studies, three pre-clinical trials, and six clinical trials. Several biomarkers were identified as particularly promising, such as the products of the peroxidation of polyunsaturated fatty acids, those of the oxidation of phenylalanine, and the hydroxyl radicals that can attack the DNA chain. Among the most promising drugs, there are those for the prevention of neurological damage, such as melatonin, retinoid lactoferrin, and vitamin E. The microbiome also has an important role in oxidative stress. In conclusion, the most recent studies show that a strong relationship between oxidative stress and prematurity exists and that, unfortunately, there is still little therapeutic evidence reported in the literature.

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Section: Proteinsmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Oxidative Stress in Preterm Infants: Overview of Current Evidence and Future Prospects

et al. 2020

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“…Similarly, we found that T3 was associated with spontaneous PTB when the fetus was male. Mechanisms of the association between thyroid hormones and PTB are poorly understood, but previous research has suggested that altered thyroid hormone concentrations may be involved in other disease states or exposures for which we have evidence of associations with PTB such as oxidative stress and in ammation [48][49][50], or environmental exposures such as phthalates [51][52][53].…”

Section: Ptb and Gestational Agementioning

confidence: 84%

Fetal Sex-Dependent Associations Between Gestational Hormone Concentrations and Adverse Birth Outcomes: A Cohort Study

Cathey

Watkins

Rosario

et al. 2020

Preprint

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Background: Adverse birth outcomes remain significant public health problems that can have long-lasting impacts on mother and child. Understanding biological mechanisms underlying these outcomes, including altered endocrine function, can inform prevention efforts. Thus, we aimed to explore associations between repeated gestational hormone measurements and birth outcomes. Secondarily, we assessed impacts of fetal sex and timing of hormone measurement on these associations. Methods: We explored associations between repeated gestational hormone measurements and birth outcomes among 976 women in PROTECT, a longitudinal prospective birth cohort in northern Puerto Rico. Birth outcomes assessed included preterm and spontaneous preterm birth (PTB), preeclampsia, gestational diabetes mellitus (GDM), small/large for gestational age (SGA, LGA), birth weight z-score, and gestational age at birth. Multivariate logistic and linear regressions were fit using pregnancy average concentrations of hormones. We also conducted sensitivity analyses assessing impacts of fetal sex and timing of hormone measurement on observed associations. Results: Among male fetuses, spontaneous PTB was associated with increased average corticotropin releasing hormone (CRH) (OR: 2.50, 95% CI: 1.19, 5.24), increased total triiodothyronine (T3) (OR: 1.80, 95% CI: 1.02, 3.16) and decreased testosterone (OR: 0.34, 95% CI: 0.15, 0.74). Odds of GDM increased with average free thyroxine (fT4) (OR: 2.80, 95% CI: 1.06, 7.41), and decreased with average testosterone (OR: 0.23, 95% CI: 0.06, 0.86). Progesterone/estriol ratio was inversely associated with birth weight z-score (b: -0.14, 95% CI: -0.27, -0.01) and gestational age (b: -0.39 weeks, 95% CI: -0.66 , -0.12), and positively associated with odds of SGA (OR: 2.08, 95% CI: 1.36, 3.19). Among females, birth weight z-score was inversely associated with progesterone (b: -0.17, 95% CI: -0.31, -0.02) and total thyroxine (T4) (b: -0.16, 95% CI: -0.30, -0.02), and GDM was inversely associated with progesterone/estriol (OR: 0.34, 95% CI: 0.12, 0.99). Conclusions: Associations between hormones and birth outcomes vary based on timing of hormone measurement and fetal sex. Future studies are needed to understand mechanisms involved in adverse birth outcomes and fetal sex differences.

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Differences in Cerebral Tissue Oxygenation in Preterm Neonates Receiving Adult or Cord Blood Red Blood Cell Transfusions

Pellegrino,

Papacci,

Beccia

et al. 2023

JAMA Netw Open

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ImportanceRepeated transfusions in preterm neonates with anemia of prematurity replace fetal hemoglobin (HbF) with adult Hb (HbA), which has a low oxygen affinity. The reduction of HbF is associated with a higher incidence of retinopathy of prematurity (ROP).ObjectiveTo assess whether HbF and HbA are differently associated with cerebral tissue oxygenation in preterm neonates.Design, Setting, and ParticipantsThis cohort study was a single-center, pilot study on cerebral oxygenation kinetics in preterm neonates with a gestational age between 24.0 weeks and 27.9 weeks who were admitted to the neonatal intensive care unit of Policlinico Universitario A. Gemelli IRCCS from December 27, 2021, to May 15, 2023. This study was ancillary to the ongoing, double-blind, multicenter Umbilical or Adult Donor Red Blood Cells in Extremely Low Gestational Age Neonates and Retinopathy of Prematurity (BORN) randomized clinical trial. The BORN trial outcome was ROP severity in neonates randomized to receive standard packed red blood cell (PRBC) transfusions obtained from RBCs of adult donors (A-RBCs) or from cord blood (CB-RBCs). According to standard procedures at the institute’s neonatal intensive care unit, patients concurrently received continuous cerebral near-infrared spectroscopy (NIRS) monitoring. This cohort study was not prespecified in the trial protocol.ExposureTransfusion with A-RBCs or CB-RBCs.Main Outcomes and MeasuresThe main outcome was the kinetics of cerebral regional oxygen saturation (crSO2) and cerebral fraction of tissue oxygen extraction (cFTOE) associated with A-RBC or CB-RBC transfusions. Cerebral NIRS monitoring was performed by neonatologists and nurses, who were blinded to the PRBC type. The NIRS monitoring was conducted starting with the blood product order, during transfusion, and for the subsequent 24 hours after transfusion completion. The mean treatment effects of A-RBCs or CB-RBCs were quantified using a linear mixed model for repeated measures.ResultsOf 23 randomized neonates, 17 (11 male [64.7%]; median gestational age at birth, 25.6 weeks [IQR, 25.3-26.1 weeks]) with a median birth weight of 840 g (IQR, 580-900 g) were included in the study; NIRS was evaluated for 42 transfusion episodes, of which 22 were A-RBCs and 20 were CB-RBCs. Globally considering all posttransfusion time points, the overall crSO2 covariate-adjusted mean after CB-RBC transfusions was 5.27% lower (95% CI, 1.20%-9.34%; P = .01) than that after A-RBC transfusions, while the cFTOE after CB-RBC transfusions was 6.18% higher (95% CI, 1.66%-10.69%; P = .009) than that after A-RBCs.Conclusions and RelevanceThe findings of this cohort study suggest that A-RBC transfusions may be associated with more oxygen delivery to cerebral tissues of preterm neonates than transfusions from CB-RBCs. This finding may explain the previously observed association between low HbF and high ROP risk. It also suggests that use of CB to meet the RBC transfusion needs of neonates with a gestational age of less than 28 weeks may protect cerebral tissues from overexposure to oxygen.

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Oxidative Stress and Preterm Birth: An Integrative Review

Abstract: Findings suggest that an imbalance between oxidants and antioxidants may be associated with PTB. The measurements and findings to date limit interpretation and understanding. Research using multidimensional methods and multidisciplinary teams are necessary to advance research and practice.

Cited by 117 publications

References 71 publications

Oxidative Stress in Preterm Infants: Overview of Current Evidence and Future Prospects

Oxidative Stress in Preterm Infants: Overview of Current Evidence and Future Prospects

Fetal Sex-Dependent Associations Between Gestational Hormone Concentrations and Adverse Birth Outcomes: A Cohort Study

Differences in Cerebral Tissue Oxygenation in Preterm Neonates Receiving Adult or Cord Blood Red Blood Cell Transfusions

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