Abstract
Aim Our study aims to evaluate the onset of oxidative stress in premature neonates during the antenatal period by quantifying chemokine levels in cord blood and to investigate a correlation between these chemokine levels and the development of prematurity-related morbidities.
Material and Method Our multicenter prospective study involved the collection of cord blood samples from neonates born at 32 weeks of gestation or below across two Level 3 NICUs. Using the multiplex cytometric bead array method, we analyzed chemokine levels in the obtained plasma samples. A cohort of patients was monitored for prematurity-related morbidities, including PDA, RDS, BPD, IVK, PVL, and mortality. The sample size comprised 32 participants meeting the inclusion criteria, following ethical approval. Patients were systematically followed for six months post-birth to assess the incidence and progression of these morbidities.
Results In our study encompassing 32 patients (59.4% male, 40.6% female) with an average gestational age of 28.5 weeks (±2.9) and average birth weight of 1206 grams (±78.2), notable associations between specific chemokines and prematurity-related morbidities were observed. We found significantly higher levels of I-TAC in patients with RDS (p=0.014, AUC 0.734), IL-8 in stage 2 and 3 BPD (p=0,022), IP-10 in cases of IVH (p=0,031), MIP-1alpha in PVL (p=0.039), MIP-3alpha in ROP (p=0.031), and IL-8 in cases resulting in death (p=0.048). Additionally, IL-8 levels exhibited variability based on the week of pregnancy. However, no significant marker was detected for PDA and NEC.
Conclusions In summary, our study underscores the pivotal role of oxidative stress, initiating during the antenatal period, in the genesis of prematurity-related morbidities among neonates. Elevated levels of chemokines, serving as indicators of oxidative stress, correlate significantly with various morbidities observed in premature infants. Notably, our findings suggest that measuring chemokine levels in cord blood holds promise as a predictive tool for identifying infants at higher risk of developing these morbidities.