The fetal-to-neonatal transition is characterized by physiologic and metabolic changes that are accompanied by a marked increase in the availability of oxygen to the body. Consequently, the pro-oxidant status may cause oxidative stress in neonates. In particular, sick preterm neonates are exposed to increased oxidative stress after birth because of exposure to supra-physiological oxygen concentrations in combination with reduced antioxidant defenses. However, few methods can determine the degree of oxidative stress in neonates both directly and quantitatively. Reactive oxygen species (ROS) can damage all types of biomolecules; oxidative damage to DNA, lipids, and proteins can be deleterious and concomitant. Recently, specific biomarkers for oxidative damage and antioxidant defenses have been introduced into perinatal medicine. This review specifically addresses pathophysiological roles of oxidative stress in neonates and presents results of our recent studies on evaluating their oxidative stress status. This review also provides data for antioxidant systems in neonates. Such information will be helpful to understand the pathogenesis and management of ROS-associated neonatal diseases, including respiratory distress syndrome and active retinopathy.
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