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Non-protein-bound iron and free radical damage in fetuses with rhesus haemolytic disease: influence of intrauterine transfusions.
BJOG 2004; 111(4):303-10BJOG

Abstract

OBJECTIVE

To determine iron-induced free radical damage in fetal rhesus haemolytic disease (RHD) before and after repeated intrauterine red blood cell transfusions and its relation to hydrops fetalis.

DESIGN

Prospective, observational study.

SETTING

Department of Obstetrics, Leiden University Medical Centre, the Netherlands.

POPULATION

Fifty anaemic fetuses, including 13 hydropic ones, 9 preterm and 12 term neonates and 8 female non-pregnant adults.

METHODS

Venous blood plasma samples were collected from 50 fetuses suffering from RHD preliminary to the first, and if appropriate, subsequent intrauterine red blood cell transfusions for determination of iron status including non-protein-bound iron (NPBI) and iron-binding primary antioxidant proteins, total plasma anti-oxidant capacity and its contributing secondary antioxidants (e.g. vitamin C, uric acid, sulphydryl groups and peroxidation products). Results were compared with values of healthy preterm and term neonates directly at birth and adult controls. Within the fetal haemolytic group, 13 hydropic fetuses were analysed as a separate group.

MAIN OUTCOME MEASURES

Non-protein-bound iron, antioxidants, total antioxidant capacity and peroxidation products. Sub analysis of the outcome measures of the hydropic fetuses.

RESULTS

RHD fetuses had at initial cordocentesis a significantly higher NPBI level and a significantly lower total plasma antioxidant capacity than control babies and adults. Their vitamin C tended to be more oxidised but lipid peroxidation had not increased, when compared with preterm babies. The repeated intrauterine red blood cell transfusions had a positive effect on the total antioxidant capacity of plasma and did not increase the concentration of NPBI. The hydropic fetuses, who had higher NPBI concentrations and lower plasma protein concentrations and total antioxidant capacity, did not show more peroxidation products in plasma than the non-hydropic fetuses. Fetuses without reversal of hydrops despite intrauterine transfusions showed decreasing levels of proteins with subsequent transfusions but peroxidation products remained constant.

CONCLUSION

Repeated intrauterine red blood cell transfusions do not lead to free radical damage in the fetus in utero. Iron-induced free radical activity does not appear to play a causative role in the proceeding of hydrops fetalis in RHD.

Authors+Show Affiliations

Department of Obstetrics, Leiden University Medical Centre, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15008763

Citation

Luykx, L M., et al. "Non-protein-bound Iron and Free Radical Damage in Fetuses With Rhesus Haemolytic Disease: Influence of Intrauterine Transfusions." BJOG : an International Journal of Obstetrics and Gynaecology, vol. 111, no. 4, 2004, pp. 303-10.
Luykx LM, Berger HM, Geerdink J, et al. Non-protein-bound iron and free radical damage in fetuses with rhesus haemolytic disease: influence of intrauterine transfusions. BJOG. 2004;111(4):303-10.
Luykx, L. M., Berger, H. M., Geerdink, J., Kanhai, H. H., & Egberts, J. (2004). Non-protein-bound iron and free radical damage in fetuses with rhesus haemolytic disease: influence of intrauterine transfusions. BJOG : an International Journal of Obstetrics and Gynaecology, 111(4), pp. 303-10.
Luykx LM, et al. Non-protein-bound Iron and Free Radical Damage in Fetuses With Rhesus Haemolytic Disease: Influence of Intrauterine Transfusions. BJOG. 2004;111(4):303-10. PubMed PMID: 15008763.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Non-protein-bound iron and free radical damage in fetuses with rhesus haemolytic disease: influence of intrauterine transfusions. AU - Luykx,L M, AU - Berger,H M, AU - Geerdink,J, AU - Kanhai,H H H, AU - Egberts,J, PY - 2004/3/11/pubmed PY - 2004/4/13/medline PY - 2004/3/11/entrez SP - 303 EP - 10 JF - BJOG : an international journal of obstetrics and gynaecology JO - BJOG VL - 111 IS - 4 N2 - OBJECTIVE: To determine iron-induced free radical damage in fetal rhesus haemolytic disease (RHD) before and after repeated intrauterine red blood cell transfusions and its relation to hydrops fetalis. DESIGN: Prospective, observational study. SETTING: Department of Obstetrics, Leiden University Medical Centre, the Netherlands. POPULATION: Fifty anaemic fetuses, including 13 hydropic ones, 9 preterm and 12 term neonates and 8 female non-pregnant adults. METHODS: Venous blood plasma samples were collected from 50 fetuses suffering from RHD preliminary to the first, and if appropriate, subsequent intrauterine red blood cell transfusions for determination of iron status including non-protein-bound iron (NPBI) and iron-binding primary antioxidant proteins, total plasma anti-oxidant capacity and its contributing secondary antioxidants (e.g. vitamin C, uric acid, sulphydryl groups and peroxidation products). Results were compared with values of healthy preterm and term neonates directly at birth and adult controls. Within the fetal haemolytic group, 13 hydropic fetuses were analysed as a separate group. MAIN OUTCOME MEASURES: Non-protein-bound iron, antioxidants, total antioxidant capacity and peroxidation products. Sub analysis of the outcome measures of the hydropic fetuses. RESULTS: RHD fetuses had at initial cordocentesis a significantly higher NPBI level and a significantly lower total plasma antioxidant capacity than control babies and adults. Their vitamin C tended to be more oxidised but lipid peroxidation had not increased, when compared with preterm babies. The repeated intrauterine red blood cell transfusions had a positive effect on the total antioxidant capacity of plasma and did not increase the concentration of NPBI. The hydropic fetuses, who had higher NPBI concentrations and lower plasma protein concentrations and total antioxidant capacity, did not show more peroxidation products in plasma than the non-hydropic fetuses. Fetuses without reversal of hydrops despite intrauterine transfusions showed decreasing levels of proteins with subsequent transfusions but peroxidation products remained constant. CONCLUSION: Repeated intrauterine red blood cell transfusions do not lead to free radical damage in the fetus in utero. Iron-induced free radical activity does not appear to play a causative role in the proceeding of hydrops fetalis in RHD. SN - 1470-0328 UR - https://www.unboundmedicine.com/medline/citation/15008763/Non_protein_bound_iron_and_free_radical_damage_in_fetuses_with_rhesus_haemolytic_disease:_influence_of_intrauterine_transfusions_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1470-0328&date=2004&volume=111&issue=4&spage=303 DB - PRIME DP - Unbound Medicine ER -