Maturation of the antioxidant system and the effects on preterm birth

The study of the interplay of the generation of reactive oxygen and nitrogen species with their related antioxidant enzymes at the maternal–placental–fetal interfaces during normal and abnormal pregnancy is in its ‘infancy’. Our understanding of the role of antioxidant systems during fetal and neonatal development is constantly changing with research better defining the biological roles of these highly reactive species and the maintenance of optimal oxidant/antioxidant balance. The antioxidant enzyme system is upregulated during the last 15% of gestation, a timeframe when non-enzymatic antioxidants are also crossing the placenta in increasing concentrations. These developmental changes provide for the transition from the relative hypoxia of intrauterine development to the oxygen-rich extrauterine environment. Preterm birth is associated with an increased oxidant burden which places these infants at much higher risk of injury. This is especially true since studies have failed to reveal significant induction of antioxidants in response to the increased generation of these reactive species. Improved understanding of these relationships will be necessary for the development of rational treatments aimed at improving pregnancy outcomes and reducing the burden of oxidative stress to premature newborns.