From vulnerability to resilience: unraveling the role of oxidative stress in preterm brain injury

Abstract Neonatal medicine advancements have significantly improved preterm infants’ survival rates, yet optimizing their neurodevelopmental outcomes, is challenging. A central factor in these challenges is oxidative stress (OS), arising from an imbalance between free radicals (FRs) production and a...

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Main Authors: Qianqian Jiang, Jialin Wen, Yingxue Ding, Hong Cui
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Italian Journal of Pediatrics
Subjects:
Online Access:https://doi.org/10.1186/s13052-025-02079-4
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author Qianqian Jiang
Jialin Wen
Yingxue Ding
Hong Cui
author_facet Qianqian Jiang
Jialin Wen
Yingxue Ding
Hong Cui
author_sort Qianqian Jiang
collection DOAJ
description Abstract Neonatal medicine advancements have significantly improved preterm infants’ survival rates, yet optimizing their neurodevelopmental outcomes, is challenging. A central factor in these challenges is oxidative stress (OS), arising from an imbalance between free radicals (FRs) production and antioxidant defense mechanisms. In preterm infants, OS is particularly detrimental due to their underdeveloped antioxidant systems, high brain metabolic demands, immature blood-brain barrier (BBB), and increased vulnerability to inflammation and hypoxia. This review focuses on the multifaceted aspects of OS concerning preterm brain injury. It examines developmental, physiological, pathological, and environmental factors contributing to preterm infants’ susceptibility to OS. In addition, the review discusses various pathophysiological mechanisms of preterm brain injury and proposes comprehensive solutions, including the use of antioxidants, nutritional support with a focus on breast milk, tailored oxygen therapy, and the importance of reducing oxidative stressors in the neonatal intensive care unit (NICU) including effective pain management and environmental modifications. The review emphasizes the need for future research focused on developing integrated and individualized treatment approaches for brain injury in preterm infants. Specifically, a deeper understanding and effective management of OS is crucial for enhancing long-term prognoses in this vulnerable group.
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spelling doaj-art-aee9730d6fe74e498e5207bb8052979d2025-08-20T04:03:02ZengBMCItalian Journal of Pediatrics1824-72882025-07-0151112010.1186/s13052-025-02079-4From vulnerability to resilience: unraveling the role of oxidative stress in preterm brain injuryQianqian Jiang0Jialin Wen1Yingxue Ding2Hong Cui3Department of Pediatrics, Beijing Friendship Hospital, Capital Medical UniversityDepartment of Pediatrics, Beijing Friendship Hospital, Capital Medical UniversityDepartment of Pediatrics, Beijing Friendship Hospital, Capital Medical UniversityDepartment of Pediatrics, Beijing Friendship Hospital, Capital Medical UniversityAbstract Neonatal medicine advancements have significantly improved preterm infants’ survival rates, yet optimizing their neurodevelopmental outcomes, is challenging. A central factor in these challenges is oxidative stress (OS), arising from an imbalance between free radicals (FRs) production and antioxidant defense mechanisms. In preterm infants, OS is particularly detrimental due to their underdeveloped antioxidant systems, high brain metabolic demands, immature blood-brain barrier (BBB), and increased vulnerability to inflammation and hypoxia. This review focuses on the multifaceted aspects of OS concerning preterm brain injury. It examines developmental, physiological, pathological, and environmental factors contributing to preterm infants’ susceptibility to OS. In addition, the review discusses various pathophysiological mechanisms of preterm brain injury and proposes comprehensive solutions, including the use of antioxidants, nutritional support with a focus on breast milk, tailored oxygen therapy, and the importance of reducing oxidative stressors in the neonatal intensive care unit (NICU) including effective pain management and environmental modifications. The review emphasizes the need for future research focused on developing integrated and individualized treatment approaches for brain injury in preterm infants. Specifically, a deeper understanding and effective management of OS is crucial for enhancing long-term prognoses in this vulnerable group.https://doi.org/10.1186/s13052-025-02079-4Brain injuryOxidative stressSusceptibilityAntioxidant strategiesPreterm infants
spellingShingle Qianqian Jiang
Jialin Wen
Yingxue Ding
Hong Cui
From vulnerability to resilience: unraveling the role of oxidative stress in preterm brain injury
Italian Journal of Pediatrics
Brain injury
Oxidative stress
Susceptibility
Antioxidant strategies
Preterm infants
title From vulnerability to resilience: unraveling the role of oxidative stress in preterm brain injury
title_full From vulnerability to resilience: unraveling the role of oxidative stress in preterm brain injury
title_fullStr From vulnerability to resilience: unraveling the role of oxidative stress in preterm brain injury
title_full_unstemmed From vulnerability to resilience: unraveling the role of oxidative stress in preterm brain injury
title_short From vulnerability to resilience: unraveling the role of oxidative stress in preterm brain injury
title_sort from vulnerability to resilience unraveling the role of oxidative stress in preterm brain injury
topic Brain injury
Oxidative stress
Susceptibility
Antioxidant strategies
Preterm infants
url https://doi.org/10.1186/s13052-025-02079-4
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AT yingxueding fromvulnerabilitytoresilienceunravelingtheroleofoxidativestressinpretermbraininjury
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