Glutathione Metabolism in Neonates.

Preterm infants are subjected to increased formation of reactive oxygen species and have reduced antioxidant defenses. The resulting oxidative stress is thought to play an important role in mortality and incidence of neonatal diseases like bronchopulmonary dysplasia.
Birth is accompanied by sudden exposure to increased oxygen pressure, which results in increased formation of reactive oxygen species. In term infants, resuscitation at birth with 100% oxygen leads to increased oxidative stress and mortality. Thus, the current recommendations are to start resuscitation of all infants with 21% oxygen. However, it seems that 21% oxygen is not enough for preterm infants.
Therefore, we will determine safety, efficacy and oxidative stress of the use of different oxygen concentrations with preterm at birth.

Resuscitation after birth with 30% oxygen reduces oxidative stress and is safe in preterm infants.

1. Glutathione synthesis: at day 2 postnatal;

2. Concentration of oxidative stress markers on day 1 and day 7;

3. Apgar Score, oxygen saturation and heart rate in first 20 minutes after birth.

Preterm infants are resuscitated with different oxygen concentrations at birth.