MEASUREMENT OF SERUM MALONDIALDEHYDE (MDA) LEVELS AS A MARKER OF LIPID PEROXIDATION IN NEONATAL SEPSIS

Abstract

Neonatal sepsis remains a major problem in neonates admitted to the neonatal intensive care units, with high morbidity and mortality rates despite advances in antimicrobial therapy and supportive cares, especially in developing countries. The lipid peroxidation, as a result of reactive oxygen species (ROS) production, play a significant role in pathogenesis of multiple organ failure and septic shock associated with neonatal sepsis which contribute to high morbidity and mortality of neonatal sepsis. This a prospective study carried out to measure the serum malondialdehyde (MDA) levels as a marker of lipid peroxidation in neonates with sepsis who were admitted to the neonatal care unit at Bint-Al-Huda Maternity and Children Teaching Hospital, Thi-Qar governorate, Iraq from first of April 2010 till the end of August 2011. One-hundred eight septic newborns and sixty matched healthy neonates (thirty were full term and thirty were preterm) as control group were studied. Sepsis was confirmed by clinical manifestations and blood culture. Fifty two (48%) of septic newborns were full term and fifty six (52%) were preterm. The most common microorganism isolated from septic newborns was gram negative bacteria especially Klebsiella pp. The MDA levels were extremely higher in both full term and preterm neonates with documented sepsis than that in their corresponding controls (P-value < 0.001). These results suggest that newborn infants have insufficient defense mechanisms against free radicals. Both enzymatic and non-enzymatic antioxidant mechanisms in neonates with sepsis and usage of antioxidants drugs and vitamins in the management of neonatal sepsis need further evaluation.