FEATURES OF INTRACELLULAR ENERGY METABOLISM, PRO-OXIDANT AND ANTIOXIDANT SYSTEMS UNDER BIRTH-RELATED STRESS IN PRETERM INFANTS

The adaptation and health status of children from birth depend on the ability of the body’s regulatory systems to adjust to extrauterine conditions. Morphofunctional immaturity in preterm birth is a predictor of impaired adaptation. The adverse effects of perinatal hypoxia contribute to perinatal pathology, necessitating an understanding of pathophysiological mechanisms to guide timely diagnostic and therapeutic interventions. Aim of the study. To establish reference values for intracellular energy metabolism, pro-oxidant activity, and antioxidant defense systems in preterm infants with a gestational age of 34–36⁶⁄₇ weeks exhibiting satisfactory postnatal adaptation. Materials and methods. A clinical and laboratory study was conducted in 50 preterm infants (gestational age 34–36⁶⁄₇ weeks) with satisfactory birth conditions. Laboratory assessments included: energy metabolism (glycerol-3-phosphate dehydrogenase, succinate dehydrogenase, NADH dehydrogenase in blood lymphocytes; serum lactate/pyruvate; aerobic respiration ratio, electron transport chain efficiency); pro-oxidant system (malondialdehyde, oxidative protein modification in blood plasma); antioxidant defense system (catalase, ceruloplasmin, SH-groups, glucose-6-phosphate dehydrogenase, glutathione peroxidase, glutathione reductase, glutathione-S-transferase). The study adhered to biomedical ethics guidelines (research protocol approved 12.09.2015), with informed parental consent. Statistical analysis was performed using licensed software (Statistica v.7, Microsoft Excel with AtteStat v.12.5, MedCalc v.16.1). Normally distributed quantitative data were compared via Student’s t-test; p<0.05 was considered statistically significant. The study was part of planned research at the Department of Pediatrics, Neonatology, and Perinatal Medicine, Bukovinian State Medical University. Results and discussion. Clinical adaptation features were analyzed in preterm neonates (34–36⁶⁄₇ weeks). Despite somatic pathology and maternal risk factors during pregnancy/delivery, infants had Apgar scores of 8–10. Respiratory, cardiovascular, and other systems adapted physiologically, indicating adequate regulatory responses. Analyzed parameters of intracellular metabolism (energy supply, pro-/antioxidant systems) may serve as reference values to assess metabolic dysfunction severity in preterm infants under hypoxic conditions. Early detection of subclinical changes enables therapeutic correction, preventing neonatal dysadaptation and mitigating long-term hypoxic sequelae. Conclusions: 1. Intracellular energy metabolism, pro-oxidant, and antioxidant parameters may confirm physiological adaptation norms in preterm infants. 2. Cellular-level dysmetabolism diagnostics facilitate early subclinical pathology detection, justifying targeted therapeutic adjustments. 3. Identifying hypoxia-induced metabolic disturbances in preterm birth aims to prevent long-term perinatal pathology consequences.