Educational Review: The Impact of Perinatal Oxidative Stress on the Developing Kidney

Abstract

Oxidative stress occurs when there is an imbalance between reactive oxygen species/reactive nitrogen species and antioxidant systems. The interplay between these complex processes is crucial for normal pregnancy and fetal development; however, when oxidative stress predominates, pregnancy related complications and adverse fetal programming such as preterm birth ensues. Understanding how oxidative stress negatively impacts outcomes for the maternal-fetal dyad has allowed for the exploration of antioxidant therapies to prevent and/or mitigate disease progression. In the developing kidney, the negative impact of oxidative stress has also been noted as it relates to the development of hypertension and kidney injury mostly in animal models. Clinical research addressing the implications of oxidative stress in the developing kidney is less developed than that of the neurodevelopmental and respiratory conditions of preterm infants and other vulnerable neonatal groups. Efforts to study the oxidative stress pathway along the continuum of the perinatal period using a team science approach can help to understand the multi-organ dysfunction that the maternal-fetal dyad sustains and guide the investigation of antioxidant therapies to ameliorate the global toxicity. This educational review will provide a comprehensive and multidisciplinary perspective on the impact of oxidative stress during the perinatal period in the development of maternal and fetal/neonatal complications, and implications on developmental programming of accelerated aging and cardiovascular and renal disease for a lifetime.

Preterm birth and metabolic implications on later life: A narrative review focused on body composition

“…In immature newborns, exposure to supplemental oxygen may halt microvessel growth in the lung and retina, leading to serious short−term complications such as bronchopulmonary dysplasia and retinopathy of prematurity. In the developing kidney, the negative impact of oxidative stress related to fluctuating oxygen exposure from hyperoxia to intermittent hypoxia has also been implicated in the development of kidney injury in postnatal animal models ( 18 ). There is evidence that neonatal hyperoxia exposure increases ROS production and alters elastin and collagen distribution within the systemic vasculature with impaired endothelial function and reduced arterial dimensions and elasticity ( 19 , 20 ).…”

“…ADP was revealed to be a rapid, non-invasive and reliable technique to measure BC in infants both in research and clinical setting ( 43 ). Roggero and colleagues firstly compared FM% values in preterm infants obtained with ADP with the reference H 2 ( 18 ) O dilution technique and founded ADP precise and accurate (mean difference 0.32 ± 1.57, p = 0.53) ( 46 ). Measurements by ADP are independent of the body size and fatness ( 43 ) and are not affected by behavioral states of infant (such as quiet and alert, awake and active, and crying intensely) and urination ( 48 ).…”

The Effect of Holder Pasteurization and Different Variants on Breast Milk Antioxidants

“…Obstetrical complications, like the premature rupture of membranes [72] or preeclampsia [73], also intensify OS-induced processes. During postnatal adaptation oxidative stress may have an impact on adult diseases affecting the cardiovascular or endocrine system [74,75]. OS, similar to inflammation, promotes aging-related pathologies, endothelial dysfunction, and adverse pregnancy outcomes [76].…”

The Urinary Concentration of Trefoil Factor 3 (TFF3) in the Term and Preterm Neonates

“…ratio in the preterm children, it should be taken into consideration that the immaturity of the neonate's kidney, especially the immaturity of the renal tubules and ongoing developmental changes that occur in the tubules, may lead to the elevated secretion of TFF3 and its excretion in the urine [41]. Also, perinatal stress, including oxidative stress, cannot be ignored as it may have a negative impact on the developing kidney [42]. Moreover, preterm birth itself can cause subclinical kidney damage [6].…”