Malondialdehyde Adduct to Hemoglobin: A New Marker of Oxidative Stress Suitable for Full-Term and Preterm Neonates

Oxidative stress may play a central role in the onset of many diseases during the neonatal period. Malondialdehyde (MDA) is a marker of lipid peroxidation. The aim of this study was to evaluate a new marker, the malondialdehyde adduct to hemoglobin (MDA-Hb), which is measured in red blood cells (RBCs) and thus does not require that an additional blood sample be drawn. In this prospective study, we first adapted the measurement method previously described to Hb solutions obtained from washed RBCs and then evaluated the suitability of the method for use in neonates. MDA-Hb concentrations were measured by liquid chromatography-mass spectrometry. We compared the concentrations of MDA-Hb between preterm and term neonates. Erythrocyte samples were collected at birth from 60 healthy neonates (29 full-term and 31 preterm), as well as from 50 preterm neonates with uncomplicated postnatal evolution during the first months of life. We found a significantly higher MDA-Hb concentration at birth in preterm neonates (P = 0.002). During the first months of life, MDA-Hb concentrations were 9.4 nanomol/g Hb in hospitalized preterm neonates. MDA-Hb could be used to assess oxidative stress in preterm neonates. Together with clinical variables, it could be a useful marker for oxidative stress exposition in these higher risk patients.