Neonatal Research Group, Health Research Institute La Fe, Valencia, Spain.
Department of Physiology, Faculty of Medicine, University of Valencia-INCLIVA, CIBERER, Spain.
Semin Fetal Neonatal Med. 2020 Apr;25(2):101090. doi: 10.1016/j.siny.2020.101090. Epub 2020 Jan 25.
Preterm infants frequently require positive pressure ventilation and oxygen supplementation in the first minutes after birth. It has been shown that the amount of oxygen provided during stabilization, the oxygen load, if excessive may cause hyperoxia, and oxidative damage to DNA. Epidemiologic studies have associated supplementation with pure oxygen in the first minutes after birth with childhood cancer. Recent studies have shown that the amount of oxygen supplemented to preterm infants after birth modifies the epigenome. Of note, the degree of DNA hyper-or hypomethylation correlates with the oxygen load provided upon stabilization. If these epigenetic modifications would persist, oxygen supplied in the first minutes after birth could have long term consequences. Further studies with a robust power calculation and long-term follow up are needed to bear out the long-term consequences of oxygen supplementation during postnatal stabilization of preterm infants.
早产儿在出生后的最初几分钟内经常需要正压通气和氧气补充。已经表明，在稳定过程中提供的氧气量（如果过多）可能会导致高氧血症和 DNA 氧化损伤。流行病学研究表明，出生后最初几分钟内用纯氧补充早产儿与儿童癌症有关。最近的研究表明，出生后补充给早产儿的氧气量会改变表观基因组。值得注意的是，DNA 超甲基化或低甲基化的程度与稳定时提供的氧气负荷有关。如果这些表观遗传修饰持续存在，出生后最初几分钟提供的氧气可能会产生长期后果。需要进行具有强大功效计算和长期随访的进一步研究，以证实早产儿出生后稳定期间补充氧气的长期后果。
