Oxygen for intrauterine resuscitation: Investigating the role of oxidative stress

宫内复苏的氧气：研究氧化应激的作用

基本信息

批准号：
9977686
负责人：
Nandini Raghuraman
金额：
$ 15.24万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-06-17 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9977686
关键词：
4 hydroxynonenal Address Adult Air American College of Obstetricians and Gynecologists Blood Categories Cell Death Cerebral Palsy Cesarean section Clinical Clinical Trials Cohort Studies Country Data Delivery Rooms Dose Exposure to Fetal Monitoring Fetus Free Radicals Functional disorder Funding Generations Goals Hyperbaric Oxygenation Hypoxia Infant Inflammatory Response Knowledge Link Lipid Peroxidation Lipids Malondialdehyde Mediating Mothers Neonatal Nursing Nucleic Acids Observational Study Obstetrical Nursing Outcome Outcome Study Oxidative Stress Oxygen Oxygen Therapy Care Pathway interactions Patients Pattern Perinatal Proteins Randomized Randomized Controlled Trials Reactive Oxygen Species Resuscitation Retinal Diseases Risk Role Safety Schedule Serum Serum Markers Structure of umbilical artery Supplementation Techniques Testing Time Time trend Tissues Umbilical cord structure United States Urine Woman Women&apos s Health Work adverse outcome animal data base cell injury clinical practice design evidence base fetal fetus hypoxia in utero intrapartum maternal serum neonatal hypoxic-ischemic brain injury neonatal morbidity neonatal resuscitation neonate neurodevelopment pilot trial prevent randomized controlled design trend trial comparing

项目摘要

Project Summary/Abstract Approximately 2/3 of laboring women receive supplemental oxygen (O2) in an attempt to reverse perceived fetal hypoxia on electronic fetal monitoring (EFM). O2 supplementation is most commonly used in patients with Category II EFM, a class of EFM patterns designed in part to identify fetal acidemia. This liberal use of O2 in laboring patients is concerning because hyperoxygenation in infants is associated with adverse outcomes including retinopathy and abnormal neurodevelopment. Furthermore, excess O2 exposure is linked to free radical generation and subsequent oxidative cell damage. This calls for a closer look at the safety of intrauterine O2 exposure. The proposed project explores potential mechanisms for harm with maternal O2 supplementation in laboring patients with Category II EFM. Specifically, this project will determine the effect of O2, compared to room air (RA), on umbilical cord and maternal serum levels of malondialdehyde (MDA) and 4-hydroxynonenal (4- HNE), markers of free radical-induced oxidative stress. The study will also explore the feasibility of using urine markers of oxidative stress as a less invasive alternative to serum markers and to establish temporal trends in oxidative stress throughout labor. This project will employ a randomized controlled design based on a recently completed pilot trial that demonstrated feasibility of such an approach. The expected outcome of this study is high-quality, mechanistic, pilot data on the pathophysiology of in-utero O2 exposure. If the central hypothesis that intrauterine exposure to O2 during labor is less safe than RA is confirmed, the findings will impact the intrapartum management of millions of patients who labor and deliver each year in the United States. Ultimately, this work will lead to evidence-based intrauterine resuscitation during labor that minimizes neonatal morbidity.

项目摘要/摘要大约2/3的劳动妇女接受补充氧（O2），以逆转感知的胎儿电子胎儿监测（EFM）缺氧。补充O2最常用于患者 II类EFM，一类EFM模式，部分旨在鉴定胎儿酸血症。这种自由使用O2在劳动患者是因为婴儿的过度氧化与不良后果有关包括视网膜病和神经发育异常。此外，多余的O2暴露与自由基有关生成和随后的氧化细胞损伤。这需要仔细研究宫内O2的安全性接触。拟议的项目探讨了对母体O2补充造成伤害的潜在机制具有II类EFM的劳动患者。具体而言，与房间相比，该项目将确定O2的效果空气（RA），脐带和孕妇血清水平水平（MDA）和4-羟基烯烯（4-- HNE），自由基诱导的氧化应激的标记。该研究还将探索使用尿液的可行性氧化应激的标志物是血清标记物的侵入性较小的替代品，并建立时间趋势整个分娩过程中的氧化应激。该项目将采用基于最近的随机控制设计完成的试验试验证明了这种方法的可行性。这项研究的预期结果是高质量，机械性的试验数据，涉及UTERO内O2暴露的病理生理学。如果中央假设在劳动期间，宫内暴露于O2的安全性比RA确认的不太安全，这些发现将影响在美国每年劳动和分娩的数百万患者的全部管理。最终，这项工作将导致劳动期间基于证据的子宫内复苏，从而最大程度地减少新生儿发病率。