Associations Between Oxidative Stress Marker Non-Protein-Bound Iron And Small Gestational Age Infants

Objective: To explore the role of non-protein-bound iron(NPBI),lipid peroxide 8-isoprostagladin F2α(8-iso-PGF2α)and malondialdehyde(MDA)in the occurrence of small-for-gestational-age infants(SGA)by detecting(their)in umbilical arterial blood of SGA,and so as to determine whether these oxidative stress indicators have predictive value to SGA;Combined with the clinical adverse factors of SGA,further explore the possible pathogenesis of SGA.Methods:A total of 68 neonates who were born in the obstetrics department of the Haikou Hospital Affiliated to Xiangya School of Medicine,Central South University from March 2021 to December 2021 were included in the gestational mothers with high-risk factors and the healthy mothers during the same period.The infants were divided into SGA group(34 cases)and AGA group(34 cases)according to their weight at birth,and umbilical artery blood was collected from each neonate group,respectively.The levels of NPBI were detected by Bleomycin assay which overcomes the matrix effect,and the levels of lipid peroxide8-iso-PGF2α and MDA were detected by ELISA.The clinical datas of all newborns and mothers in each study group were all collected,and SPSS23.0 software was used for data sorting and statistical analysis of the research results and data.Results:(1)The mean gestational age at birth in the SGA group was(37.73±1.69)weeks,while the AGA group was(37.85±1.74)weeks;the sex ratio of newborns in the SGA group was 0.7:1(14 males and 20 females),and the AGA group was 1:1(17 males and 17 females);the mean birth weight of the SGA group was(2.45±0.56)kg,and the AGA group was(3.28±0.51)kg.There was no significant difference in gestational age sex ratio between the two groups of newborns(P>0.05).(2)The levels of NPBI,8-iso-PGF2α and MDA in umbilical artery blood in SGA group were significantly higher than those in AGA group(P<0.05);univariate logistic regression analysis showed that NPBI,8-iso-PGF2α and MDA were risk factors of SGA(P<0.05),after multivariate logistic regression analysis,only NPBI was an independent risk factor for the incidence of SGA(P<0.05).(3)There is a correlation between the NPBI level and the 8-iso-PGF2α(r=0.582,P=0.001),MDA(r=0.371,P=0.031)in the SGA group);and a correlation between NPBI level and MDA level(r=0.492,P=0.003)while no correlation between NPBI level and 8-iso-PGF2α(r=0.032,P=0.859)in the AGA group.(4)The ROC curve shows that umbilical artery blood NPBI combined with 8-iso-PGF2α have the greatest predictive performance for SGA,the sensitivity is 74.4%,the specificity is 96%,and the AUC is0.879(95%CI :0.796-0.962,P < 0.05).(5)Gestational hypertension(OR=4.628,95%CI: 1.088-19.689)and anemia during pregnancy(OR=4.227,95%CI: 1.121-15.941)were independent risk factors for SGA(P <0.05,OR>1).(6)The levels of NPBI,8-iso-PGF2α and MDA in umbilical arterial blood were all positively correlated with gestational hypertension(r=0.392,P=0.001;r=0.412,P=0.001;r=0.315,P=0.009)and Anemia during pregnancy(r=0.454,P=0.001;r=0.356,P=0.003;r=0.375,P=0.003));and compared with anemia during pregnancy,the levels of NPBI,8-iso-PGF2α and MDA have higher association with thalassemia(r=0.504,P=0.001;r=0.396,P=0.001;r=0.398,P=0.001).Conclusion:(1)NPBI,lipid peroxide 8-iso-PGF2α,MDA are correlated with SGA;NPBI combined with lipid peroxide 8-iso-PGF2α have certain predictive value for SGA.(2)NPBI participates in the pathophysiological mechanism of SGA by mediating lipid peroxidative damage.(3)Gestational hypertension and thalassemia may cause the occurrence of SGA through NPBI-induced oxidative stress.