Neonatal Brain Hemorrhage: The Role of NonProtein-Bound Iron

Abstract

Abstract Intraventricular hemorrhage (IVH) in very preterm infants is a common disease, which can induce long-term consequences. Oxidative stress (OS) occurs easily in preterm newborns due to an imbalance between high free radical (FR) production and the low antioxidant shield, not completely developed at birth. Nonprotein-bound iron (NPBI) concentration in cord blood has been found to be highly predictive for the risk of poor neurodevelopmental outcome. However, at present, no data exist about the exact mechanisms associated with IVH induced by iron-mediated FRs. We propose the hypothesis that hypoxia or ischemia-induced releasing of NPBI is a key regulating event that initiates a vicious circle of excessive FR generation, which in turn participates in edema development, inflammatory reaction, and endothelial injury. This suggests that developing effective neuroprotective strategies for preterm infants requires a detailed understanding of OS reactions and glial responses.