Plasma Proteins in Acute and Chronic Lung Disease of the Newborn

Moison, Ralf M.W.; Haasnoot, Adriaan A; Zoeren‐Grobben, Diny van; Berger, Howard

doi:10.1016/s0891-5849(98)00070-7

Cited by 31 publications

(17 citation statements)

References 37 publications

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“…It was not always possible to obtain enough material for all laboratory tests. The values of the controls are similar to those published before 8,14 and a trend of increasing antioxidant capacity with gestational age is seen in the newborn babies. The results of the RHD fetuses differed significantly from those of the adults for all variables except for uric acid.…”

Section: Resultssupporting

confidence: 83%

“…Venous heparinised blood was also obtained from healthy Caucasian females, not pregnant and not receiving vitamin or iron supplements, aged 24–50 years ( n = 8). These samples were used to verify trends and outcomes of the present analyses with those previously published 8,14,25 …”

Section: Methodsmentioning

confidence: 97%

“…This NPBI is considered as a major factor in the development of oxygen radical disease of prematurity (e.g. respiratory distress syndrome, retinopathy, and hypoxic/ischaemic encephalopathy of the newborn) 13–21 …”

Section: Introductionmentioning

confidence: 99%

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Non‐protein‐bound iron and free radical damage in fetuses with rhesus haemolytic disease: influence of intrauterine transfusions

Luykx

Berger

Geerdink

et al. 2004

BJOG

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Objective To determine iron-induced free radical damage in fetal rhesus haemolytic disease (RHD) before and after repeated intrauterine red blood cell transfusions and its relation to hydrops fetalis. Design Prospective, observational study.Setting Department of Obstetrics, Leiden University Medical Centre, the Netherlands.Population Fifty anaemic fetuses, including 13 hydropic ones, 9 preterm and 12 term neonates and 8 female non-pregnant adults. Methods Venous blood plasma samples were collected from 50 fetuses suffering from RHD preliminary to the first, and if appropriate, subsequent intrauterine red blood cell transfusions for determination of iron status including non-protein-bound iron (NPBI) and iron-binding primary antioxidant proteins, total plasma antioxidant capacity and its contributing secondary antioxidants (e.g. vitamin C, uric acid, sulphydryl groups and peroxidation products). Results were compared with values of healthy preterm and term neonates directly at birth and adult controls. Within the fetal haemolytic group, 13 hydropic fetuses were analysed as a separate group. Main outcome measures Non-protein-bound iron, antioxidants, total antioxidant capacity and peroxidation products. Sub analysis of the outcome measures of the hydropic fetuses. Results RHD fetuses had at initial cordocentesis a significantly higher NPBI level and a significantly lower total plasma antioxidant capacity than control babies and adults. Their vitamin C tended to be more oxidised but lipid peroxidation had not increased, when compared with preterm babies. The repeated intrauterine red blood cell transfusions had a positive effect on the total antioxidant capacity of plasma and did not increase the concentration of NPBI. The hydropic fetuses, who had higher NPBI concentrations and lower plasma protein concentrations and total antioxidant capacity, did not show more peroxidation products in plasma than the non-hydropic fetuses. Fetuses without reversal of hydrops despite intrauterine transfusions showed decreasing levels of proteins with subsequent transfusions but peroxidation products remained constant. Conclusion Repeated intrauterine red blood cell transfusions do not lead to free radical damage in the fetus in utero. Iron-induced free radical activity does not appear to play a causative role in the proceeding of hydrops fetalis in RHD.

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Section: Resultssupporting

confidence: 83%

Section: Methodsmentioning

confidence: 97%

See 1 more Smart Citation

Non‐protein‐bound iron and free radical damage in fetuses with rhesus haemolytic disease: influence of intrauterine transfusions

Luykx

Berger

Geerdink

et al. 2004

BJOG

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“…Moreover, as albumin and plasma proteins help preserve microvascular integrity, by limiting the increase in capillary permeability and by reducing the peripheral vasodilatation, a self-reinforcing circle may occur in acute diseases [21,22]. This hypothesis is consistent with our results that hypoproteinemia at 12 h of life is significantly more frequent in some perinatal morbidities, such as acute birth anemia and severe RDS, in which systemic or organ capillary permeability is impaired [23]. …”

Section: Discussionsupporting

confidence: 87%

Low Plasma Protein Levels at Birth Are Associated with Poor Cardiovascular Adaptation and Serious Adverse Outcome in Infants with Gestational Age <32 Weeks: The ProHémie Study

Bonsante¹,

Ramful²,

Sampériz³

et al. 2017

Neonatology

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Background: Retrospective studies suggest that early hypoproteinemia has prognostic value for adverse outcome in preemies, but the underlying pathophysiology is unknown. We hypothesized that the prognostic relevance of hypoproteinemia could be related to its association with impaired cardiovascular function and organ perfusion during transition. Objectives: To describe the plasma protein status and the measures of cardiovascular function according to the outcome in infants <32 weeks' gestation. Methods: One hundred and twenty-eight infants were prospectively included from birth to discharge. During the first 24 h of life, we assessed the cardiovascular function and systemic and organ blood flow by Doppler ultrasound, and monitored cerebral and renal regional oxygen saturation (cRSO₂, rRSO₂) using near-infrared spectroscopy. These measures were analyzed in relationship to hypoproteinemia (total plasma protein level <40 g/L at 12 h of life) and severe adverse outcome (death or survival with severe neurological injury). Results: Hypoproteinemia was associated with a higher risk of a severe adverse outcome after adjustment of confounding variables (adjusted OR = 6.8; 95% CI 1.3-34). Compared to normoproteinemic infants and after adjustment for gestational age, hypoproteinemic ones had more significantly: hypotension (7 vs. 13%, p = 0.03), abnormal capillary refilling time (20 vs. 36%, p < 0.001), abnormal renal blood flow (resistive index 0.78 ± 0.11 vs. 0.85 ± 0.09, p = 0.04), lower rRSO₂ (82.9 ± 9.2 vs. 73.6 ± 10.5%, p = 0.04), and lower systemic vascular resistance (0.155 ± 0.058 vs. 0.108 ± 0.037 mm Hg/L/kg; p = 0.04). The cRSO₂ patterns were significantly decreased in infants with severe adverse outcome and independent from protein status. Conclusion: Hypoproteinemia is associated with impaired cardiovascular function. Further studies are required to elucidate the interplay between changes in protein levels, postnatal hemodynamics and clinical outcome.

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“…However, there is lack of evidence that normoalbuminaemia reduces morbidity and mortality in neonates,1 2 albeit in very low birthweight babies, hypoalbuminaemia has been shown to be associated with increased mortality 3. There is also another theory based on the fact that since albumin contributes to antioxidant capacity of plasma, low levels of plasma albumin may lessen the total plasma antioxidant capacity, thereby predisposing hypoalbuminaemic neonates to diseases where reactive oxygen species play a role, such as in necrotising enterocolitis,3 4 respiratory distress, chronic lung disease and intracranial haemorrhage 5…”

mentioning

confidence: 99%