Antenatal maternal corticosteroid administration and markers of oxidative stress and inflammation in umbilical cord blood from very low birth weight preterm newborn infants

Abstract

Objective: To investigate the association between antenatal maternal corticosteroid administration and blood levels of reactive oxygen intermediates (ROI), reduced glutathione (GR) and interleukin-6 (IL-6) in preterm, very low birth weight infants. Methods:This was a cohort study in which cord blood samples were used for the following tests: baseline and stimulated granulocyte ROI were measured by flow cytometry; GR was assayed by spectrophotometry; and IL-6 by enzyme-linked immunosorbent assay. Two different comparative analyses of antenatal corticosteroid (betamethasone) were conducted: the first compared administration against no administration and the second compared mothers who received the complete cycle with those given only a partial antenatal corticosteroid cycle. Maternal and neonatal variables were analyzed in order to compare groups. Categorical variables were compared using the chi-square or Fischer tests, and blood marker test results were compared using the Mann-Whitney test. Results:The different corticoid therapy groups were similar in terms of all of the maternal and neonatal variables with the exception of vaginal delivery, which was significantly associated with not receiving antenatal corticosteroid. The results for ROI, GR and IL-6 did not differ when the comparison was based on simple presence or absence of administration of the steroid. However, when the complete cycle was compared against incomplete administration, median ROI and IL-6 were lower among those given the complete cycle. Conclusion:Administration of the complete cycle of betamethasone to the mother had a suppressive effect on baseline ROI and IL-6 production in very low birth weight preterm newborn infants.J Pediatr (Rio J). 2012;88(1):61-6: Newborn, oxidative stress, reactive oxygen species, interleukin-6, glutathione. ResumoObjetivo: Avaliar a associação entre o uso materno antenatal de corticosteroide e os níveis sanguíneos de intermediários reativos de oxigênio (ROI), glutationa reduzida (GR) e interleucina-6 (IL-6) em recém-nascidos pré-termo de muito baixo peso ao nascer.Métodos: Estudo de coorte. A dosagem foi feita em sangue de cordão umbilical. A dosagem de ROI por granulócitos foi realizada por citometria de fluxo nos estados basal e estimulado; a GR, por espectrofotometria; e a IL-6, por enzyme-linked immunosorbent assay. Foram considerados dois grupos em relação ao uso de corticosteroide (betametasona) antenatal: uso ou não da medicação; e, se presente, se foi de modo completo ou parcial. Variáveis maternas e neonatais foram consideradas para efeito de comparação dos grupos. As variáveis categóricas foram comparadas usando os testes do qui-quadrado ou de Fischer, e as comparações dos valores dos marcadores sanguíneos foram feitas usando-se o teste de Mann-Whitney.Resultados: Os grupos de corticoterapia foram comparáveis em relação às variáveis maternas e neonatais, exceto a ocorrência de parto vaginal, o qual foi associado significativamente à ausência de uso de corticosteroide antenatal. Os valores de ROI...

Effect of corticosteroid interval on markers of inflammation in spontaneous preterm birth

“…These results have been reproduced in other more recent studies, showing a decrease in umbilical cord IL-6 levels after antenatal corticosteroid administration. 16,17 Similarly, our results support a significant decrease in the prevalence of elevated IL-6 levels 24-48 hours after the administration of corticosteroids. Further time course data are available from animal studies showing early transient decreases in inflammatory markers as a result of corticosteroid administration.…”

Oxidative stress markers at birth: Analyses of a neonatal population

“…Even though pregnancy generates increased oxidative burden, in normal pregnancy antioxidant capacity increases with term (Gitto et al, 2002). Furthermore, increased cytokines may stimulate production of reactive oxygen intermediates that are principally scavenged by GSH (Caldas et al, 2012). In this regard, GSH functions as a redox buffer, for instance by removing toxic peroxides via reactions catalysed by GSH peroxidase (Marrazzo et al, 2014).…”

Peri-intraventricular hemorrhage and oxidative and inflammatory stress markers in very-low birth weight newborns

“…However, protection was not observed when the birth occurred before 24 hours of the administration of the first dose (RR 0.54; 95%CI: 0.21 to 1.36), but was observed when birth occurred before 48 hours after the administration of the first dose (RR 0.26; 95%CI: 0.09 to 0.75). 36 Steroid use alone is capable of altering the response of the assessed biomarkers, with decreased production of ROI and IL-6, 27,32,34,37 and may therefore prevent such markers from expressing themselves and being factors independently associated with PIVH. However, studies with controlled exposure to antenatal steroid use, in case of premature birth danger, would not be ethical.…”